Remote-NV HEDIS & Quality Practice Advisor

Centene Corp.; Nevada (IA); Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Job summary

Centene Corp. seeks a Quality Practice Advisor to educate provider practices and IPAs on HEDIS measures, documentation guidelines and coding.

This remote Nevada-based role requires up to 75% travel to provider offices, ensuring plan compliance and quality improvement across networks. The ideal candidate has a bachelor's degree and 3+ years in HEDIS data collection and risk adjustment, with professional certifications like CCS, CPC or CBCS preferred.

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.
• Willingness to travel up to 75% to provider offices.
• Educate provider practices on HEDIS measures and coding guidelines.

Responsibilities

• Delivers, advises and educates provider practices and IPAs on HEDIS measures and coding.
• Collects, summarizes and trends provider quality and risk data for improvement opportunities.
• Collaborates with Provider Relations to boost performance in Quality and Risk Adjustment.
• Develops provider relationships across product lines and maintains KPI accuracy.

Skills

HEDIS knowledge

Medical coding

Quality improvement

Provider education

Education

Bachelor's degree

Tools

HCQM

CPHQ

Job description

Centene Corp. seeks a Quality Practice Advisor to educate provider practices and IPAs on HEDIS measures, documentation guidelines and coding.

This remote Nevada-based role requires up to 75% travel to provider offices, ensuring plan compliance and quality improvement across networks. The ideal candidate has a bachelor's degree and 3+ years in HEDIS data collection and risk adjustment, with professional certifications like CCS, CPC or CBCS preferred.