Remote Quality Practice Advisor: HEDIS & Risk Adjustment

Centene Corp.; Iowa; Hybrid; USD 37,000 - 68,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Job summary

Centene Corp. is seeking a Quality Practice Advisor to advance HEDIS measures and risk adjustment by educating provider practices and IPAs and guiding documentation and coding to meet NCQA standards.

The role requires 3+ years in HEDIS record collection and risk adjustment, a Bachelor's degree or equivalent, and the ability to travel up to 75% across Central/Southeastern IA areas while supporting nationwide provider networks. Remote work options available with flexible schedules.

Qualifications

• Bachelor's Degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.
• Licenses/certifications such as CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS are acceptable.

Responsibilities

• Establishes and fosters a healthy working relationship between large physician practices, IPAs and Centene.
• Educates providers and supports provider practice sites regarding NCQA HEDIS measures and risk adjustment.
• Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data.
• Delivers education for HEDIS measures, medical record documentation and coding.
• Travels up to 75% to provider offices.

Skills

HEDIS knowledge

Education

Bachelor's Degree or equivalent

Job description

Centene Corp. is seeking a Quality Practice Advisor to advance HEDIS measures and risk adjustment by educating provider practices and IPAs and guiding documentation and coding to meet NCQA standards.

The role requires 3+ years in HEDIS record collection and risk adjustment, a Bachelor's degree or equivalent, and the ability to travel up to 75% across Central/Southeastern IA areas while supporting nationwide provider networks. Remote work options available with flexible schedules.