Provider Quality & Engagement Liaison

Centene Corporation; Nevada (IA); On-site; USD 27,000 - 45,000; Full time

Job summary

Centene Corporation in Nevada seeks a healthcare quality specialist focused on provider engagement, HEDIS, CAHPS and quality improvement initiatives. The role involves collaborating with plan providers and internal teams to close performance gaps and educate sites.

Travel is required; candidates should have a high school diploma, 2+ years in quality improvement and licenses as applicable. The salary range is posted and benefits are offered.

Qualifications

• High school diploma or equivalent.
• Associate’s degree preferred.
• 2+ years of experience with clinical and member experience quality.

Responsibilities

• Connects providers with resources to educate practices in HEDIS measures, medical record documentation guidelines and Member Experience measures.
• Acts as an ongoing resource to providers for quality improvement via regular touch points and meetings.
• Educates, supports, and resolves provider practice sites issues around P4P, RxEffect, CAHPS, HOS, CTMs, Disenrollments, Appeals, and Grievances.
• Collaborates with Provider Relations and other provider facing teams to improve provider performance in Quality (Clinical and Member Experience measures).
• Develops, enhances and maintains provider relationships across all product lines (Medicare, Medicaid, Ambetter) and supports quality improvement interventions.
• Conducts telephonic outreach to members to encourage visits to physicians to close quality care gaps.
• Performs other duties as assigned.
• Complies with all policies and standards.

Skills

Provider engagement

HEDIS

Quality improvement

CAHPS

Education

High school diploma

Associate's degree preferred

Job description

Centene Corporation in Nevada seeks a healthcare quality specialist focused on provider engagement, HEDIS, CAHPS and quality improvement initiatives. The role involves collaborating with plan providers and internal teams to close performance gaps and educate sites.

Travel is required; candidates should have a high school diploma, 2+ years in quality improvement and licenses as applicable. The salary range is posted and benefits are offered.