Remote HEDIS & Quality Practice Advisor

Centene Corporation; United States; Remote; USD 37,000 - 66,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Remote/Hybrid/Field/Office work

Job summary

Centene Corporation seeks a Quality Practice Advisor to drive HEDIS education and risk-adjusted coding across multiple states. The role focuses on collaboration with physician practices and IPAs to ensure NCQA alignment and accurate documentation.

Applicants should have a Bachelor's degree, 3+ years in HEDIS collection and risk adjustment, and relevant licenses. The position supports remote work with significant travel (50%), covering regions such as KY, IN, IL, and TN.

Qualifications

• Bachelor's Degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.
• Licenses/Certifications: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS; RHIT® preferred.

Responsibilities

• Establishes and fosters a healthy relationship between large physician practices, IPAs and Centene.
• Educates providers and supports practice sites regarding NCQA HEDIS measures, documentation, and coding.
• Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS and documentation.
• Acts as a resource for health plan peers on HEDIS measures, documentation, and coding.

Skills

HEDIS knowledge

Risk adjustment

Medical coding

Provider education

Education

Bachelor's degree or equivalent

Job description

Centene Corporation seeks a Quality Practice Advisor to drive HEDIS education and risk-adjusted coding across multiple states. The role focuses on collaboration with physician practices and IPAs to ensure NCQA alignment and accurate documentation.

Applicants should have a Bachelor's degree, 3+ years in HEDIS collection and risk adjustment, and relevant licenses. The position supports remote work with significant travel (50%), covering regions such as KY, IN, IL, and TN.