Hybrid Quality Practice Advisor - HEDIS & Risk Adjustment

Centene Corporation; Asheville (NC); Hybrid; USD 37,000 - 67,000; Full time

Benefits offered by this job

Remote options

Hybrid work

Field work

Office work schedules

Job summary

Centene Corporation seeks a Provider Quality & HEDIS Specialist in North Carolina to educate and support provider practices on HEDIS measures and risk adjustment. The role focuses on improving documentation and coding to meet state and NCQA standards, with travel to provider sites up to 75%.

You'll collaborate with Provider Relations and QA teams to identify opportunities for improvement, monitor KPI performance, and drive initiatives across product lines while adhering to corporate policies and

Qualifications

• Bachelor's degree or equivalent is required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.
• RN licensure or other listed certifications preferred.

Responsibilities

• Delivers education to provider practices on HEDIS measures and coding.
• Collects and analyzes provider quality and risk adjustment data.
• Collaborates with Provider Relations to improve performance and KPI scores.
• Travel up to 75% to provider offices and clinics.

Skills

HEDIS knowledge

Provider education

Data analysis

Education

Bachelor's Degree

Job description

Centene Corporation seeks a Provider Quality & HEDIS Specialist in North Carolina to educate and support provider practices on HEDIS measures and risk adjustment. The role focuses on improving documentation and coding to meet state and NCQA standards, with travel to provider sites up to 75%.

You'll collaborate with Provider Relations and QA teams to identify opportunities for improvement, monitor KPI performance, and drive initiatives across product lines while adhering to corporate policies and