Remote HEDIS Audit & Quality Analyst

Centene Corporation; Clayton (MO); Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health insurance

401K and stock plans

Tuition reimbursement

Paid time off + holidays

Remote work flexibility

Job summary

Centene Corporation is seeking a qualified HEDIS Quality & Audit Analyst to support enterprise HEDIS quality oversight, audit readiness, and CMS submission activities. The role emphasizes documentation, adherence to NCQA and CMS standards, and collaboration with Health Plans to meet timelines and requirements.

The candidate will manage audit timelines, coordinate with cross-functional teams, and ensure audit materials are complete and defensible.

Qualifications

• Bachelor's Degree healthcare or related field or equivalent experience required.
• 2+ years of HEDIS, regulatory, audit, or quality improvement experience, preferably in a healthcare environment.

Responsibilities

• Provide support for HEDIS quality oversight, audit readiness, and submission support activities.
• Contribute to process improvement through documentation of lessons learned and enhancement opportunities.
• Perform NCQA HEDIS audit activities, including preparation and maintenance of Roadmaps, Section 5 documentation, CAHPS and measure-specific evidence.
• Manage audit and submission timelines, deliverables, and dependencies.
• Collaborate with Health Plans on reporting population validation and measure selection activities.
• Oversee CMS submission activities, including PLD coordination and submission tracking.
• Apply enterprise standards, templates, and documentation requirements across HEDIS audit deliverables.
• Identify, document, and elevate audit issues, risks, and documentation gaps.
• Lead and actively participate in audit meetings, working sessions, and internal stakeholder reviews.
• Perform quality checks to ensure audit materials are complete, accurate, and defensible.

Skills

HEDIS knowledge

Regulatory compliance

Audit support

Quality improvement

Documentation

Education

Bachelor's Degree in healthcare or related field

Job description

Centene Corporation is seeking a qualified HEDIS Quality & Audit Analyst to support enterprise HEDIS quality oversight, audit readiness, and CMS submission activities. The role emphasizes documentation, adherence to NCQA and CMS standards, and collaboration with Health Plans to meet timelines and requirements.

The candidate will manage audit timelines, coordinate with cross-functional teams, and ensure audit materials are complete and defensible.