Remote Behavioral Health HEDIS Optimization Lead
Centene Corp.
An application made for this job — a tailored resume and cover letter that speak straight to the posting.
Benefits offered by this job
Job summary
Centene Corp. is seeking an HEDIS Specialist to supervise interventions aimed at improving behavioral health HEDIS and Pay for Performance measures.
The role collaborates with health plans and clinical leadership to close care gaps and implement targeted strategies. The ideal candidate has nursing-related education and 3+ years in case/utilization management, with strong data analysis and interdepartmental liaison skills.
Qualifications
- Bachelor’s degree in nursing or related field.
- 3+ years of case/utilization management experience in behavioral or physical health.
Responsibilities
- Supervise and facilitate interventions to meet behavioral health HEDIS and P4P measures.
- Partner with health plans and regional clinical leadership to close care gaps.
- Develop and implement strategies with clinical staff to improve HEDIS metrics.
- Prepare financial impact and ROI for funded initiatives.
- Liaise with quality improvement and medical management to coordinate interventions.
- Monitor effectiveness of new and existing P4P/HEDIS initiatives and educate staff.
Skills
Education
Job description
Centene Corp. is seeking an HEDIS Specialist to supervise interventions aimed at improving behavioral health HEDIS and Pay for Performance measures.
The role collaborates with health plans and clinical leadership to close care gaps and implement targeted strategies. The ideal candidate has nursing-related education and 3+ years in case/utilization management, with strong data analysis and interdepartmental liaison skills.
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