HEDIS & Risk Adjustment Quality Advisor

Centene Management Company LLC; Indiana (PA); Hybrid; USD 37,000 - 67,000; Full time

Job summary

Centene Management Company LLC in Indianapolis, IN seeks a HEDIS Nurse Auditor who builds strong relationships with large physician practices and IPAs. You educate providers on NCQA HEDIS measures, risk adjustment, and medical record documentation, and you help resolve deficiencies to meet state and federal standards.

Travel up to 75% required. The role requires a bachelor's degree or equivalent and 3+ years in HEDIS data collection and coding; several licensure options apply.

Qualifications

• Bachelor's degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.
• Must have reliable transportation and valid driver's license. Local to Indianapolis, IN area, willing to travel up to 75%.

Responsibilities

• Establishes and fosters relationships with physician practices, IPAs and Centene.
• Educates providers on NCQA HEDIS measures and risk adjustment.
• Supports provider sites with proper medical record documentation and coding.
• Identifies and resolves deficiencies impacting plan compliance to meet standards.
• Travels up to 75% to provider offices as needed.

Skills

HEDIS data collection

Risk adjustment coding

Provider education

Education

Bachelor's Degree or equivalent

CCS

LPN

LCSW

LMHC

LMSW

LMFT

LVN

RN

APRN

HCQM

CHP

CPHQ

CPC

CPC-A

CBCS

Job description

Centene Management Company LLC in Indianapolis, IN seeks a HEDIS Nurse Auditor who builds strong relationships with large physician practices and IPAs. You educate providers on NCQA HEDIS measures, risk adjustment, and medical record documentation, and you help resolve deficiencies to meet state and federal standards.

Travel up to 75% required. The role requires a bachelor's degree or equivalent and 3+ years in HEDIS data collection and coding; several licensure options apply.