Senior HEDIS Audit & Quality Lead (Remote)

Centene Corp.; United States; Remote; USD 70,000 - 126,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Remote/Hybrid/Field or Office work

Job summary

Centene Corp. seeks an experienced Senior HEDIS Quality & Audit Analyst to lead enterprise HEDIS quality oversight and audit readiness.

You will independently interpret regulatory requirements, guide complex NCQA audit workstreams, and ensure audit-defensible documentation and submissions for NCQA and CMS. The role requires strong optimism for risk assessment, cross-functional collaboration with health plans, auditors, IT, analytics, and quality stakeholders to drive continuous improvement in

Qualifications

• Bachelor's Degree in Healthcare or related field, or equivalent experience required.
• Master's Degree in Healthcare or related field preferred.
• 4+ years related experience in HEDIS, Quality Audits, or regulated healthcare environments required.
• Project management experience in HEDIS, regulatory, audit, or quality improvement preferred.

Responsibilities

• Lead complex NCQA audit workstreams, including Roadmaps and Section 5 documentation.
• Interpret and apply federal/state regulatory requirements to HEDIS documentation, workflows, and data use.
• Identify, assess, and mitigate audit and submission risks; lead root cause analysis and corrective actions.
• Support CMS submission activities and develop enterprise standards and templates for audit readiness.

Skills

HEDIS

Quality Audits

Regulated healthcare

Education

Bachelor's degree in Healthcare

Master's degree preferred

Job description

Centene Corp. seeks an experienced Senior HEDIS Quality & Audit Analyst to lead enterprise HEDIS quality oversight and audit readiness.

You will independently interpret regulatory requirements, guide complex NCQA audit workstreams, and ensure audit-defensible documentation and submissions for NCQA and CMS. The role requires strong optimism for risk assessment, cross-functional collaboration with health plans, auditors, IT, analytics, and quality stakeholders to drive continuous improvement in