Hybrid Provider HEDIS & Quality Advisor

Centene Corporation; Texas; Hybrid; USD 37,000 - 67,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work arrangements (remote,hyb

Field or office work schedules

Job summary

Centene Corporation in Texas seeks a provider quality specialist to educate and support large physician practices and IPAs on HEDIS measures and coding. The role emphasizes data collection, analysis and collaboration with provider relations to improve Quality and Risk Adjustment performance.

Applicants should have a Bachelor’s degree and 3+ years in HEDIS record collection and risk adjustment, with relevant licenses. This hybrid role requires local travel and remote duties, with up to 75% travel.

Qualifications

• Bachelor’s Degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.
• Licenses/certifications: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS.
• RHIT certification: state-specific requirements may apply for certain roles.

Responsibilities

• Delivers, educates and advises provider practices and IPAs on HEDIS measures and coding per NCQA requirements.
• Collects, trends and reports provider quality and risk adjustment data to identify improvement opportunities.
• Collaborates with Provider Relations to improve performance in Quality, Risk Adjustment and Operations.
• Travel up to 75% to provider offices and support related duties.

Skills

HEDIS data collection

Provider education

Data analysis

Education

Bachelor’s degree or equivalent

3+ years HEDIS/risk adjustment

Job description

Centene Corporation in Texas seeks a provider quality specialist to educate and support large physician practices and IPAs on HEDIS measures and coding. The role emphasizes data collection, analysis and collaboration with provider relations to improve Quality and Risk Adjustment performance.

Applicants should have a Bachelor’s degree and 3+ years in HEDIS record collection and risk adjustment, with relevant licenses. This hybrid role requires local travel and remote duties, with up to 75% travel.