Quality Practice Advisor

RemoteWorker US; Lawton (OK); Remote; Full time

Job summary

A leading company is seeking a Quality Practice Advisor to support the Oklahoma Complete Health Plan. This remote position involves educating providers on HEDIS measures and enhancing performance. Ideal candidates will have a nursing background with HEDIS experience and relevant certifications. The role offers comprehensive benefits and a competitive pay range.

Benefits

Health insurance

401K

Stock plans

Tuition reimbursement

Paid time off

Flexible work arrangements

Qualifications

• 3+ years in HEDIS record collection and risk adjustment coding.
• Relevant certifications such as CCS, LPN, LCSW, RN, APRN.

Responsibilities

• Educate providers on HEDIS measures, documentation guidelines, and coding standards.
• Analyze provider performance data to identify improvement opportunities.
• Collaborate with provider relations teams.

Skills

HEDIS background

Risk adjustment coding

Provider education

Education

Bachelor's Degree or equivalent

Job description

Join to apply for the Quality Practice Advisor role at RemoteWorker US.

This position is remote/work from home, with a preference for applicants residing in Oklahoma. Travel up to 10% to provider offices may be required if residing in Oklahoma. The role supports the Oklahoma Complete Health Plan.

Work schedule: Monday - Friday, 8am - 5pm Central Time. Ideal candidate will be a nurse with HEDIS background.

Position Purpose:

Establishes and fosters relationships with physician practices, IPAs, and Centene. Educates providers on NCQA HEDIS measures, risk adjustment, medical record documentation, and coding. Supports plan compliance and quality improvement initiatives.

Responsibilities include:

• Educate providers on HEDIS measures, documentation guidelines, and coding standards.
• Analyze provider performance data to identify improvement opportunities.
• Collaborate with provider relations teams to enhance performance.
• Identify support needs of practices.
• Maintain provider relationships across product lines.
• Ensure quality KPIs and HEDIS accuracy standards are met.
• Travel up to 10% as needed.
• Perform additional duties as assigned.

Qualifications:

• Bachelor's Degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment coding.
• Relevant certifications such as CCS, LPN, LCSW, RN, APRN, etc.

Compensation and Benefits:

Pay range: $26.50 - $47.59/hour. Benefits include health insurance, 401K, stock plans, tuition reimbursement, paid time off, and flexible work arrangements.

Centene is an equal opportunity employer committed to diversity. All qualified applicants will be considered without regard to protected characteristics.