Traveling HEDIS & Quality Improvement Advisor

Centene Corp.; Paducah (KY); Hybride; USD 3 722 000 - 6 688 000; Plein temps

Résumé du poste

Centene Corp. is seeking a Quality Practice Advisor to establish and foster productive relationships with large physician practices and IPAs.

The role educates providers on NCQA HEDIS measures, risk adjustment, documentation, and coding to ensure plan compliance with state and federal standards. The position requires significant travel across KY, southern Indiana, Illinois and Tennessee regions and offers flexible remote/hybrid/field options.

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.

Responsabilités

• Travels up to 50% of the time to provider offices.
• Delivers, advises and educates provider practices and IPAs on HEDIS measures and coding.
• Collects, summarizes, trends and delivers provider quality and risk adjustment performance data.
• Collaborates with Provider Relations and other provider-facing teams to improve performance in Quality, Risk Adjustment and Operations.
• Identifies provider needs where Centene can provide support and maintains provider relationships.
• Maintains Quality KPI and HEDIS abstraction accuracy.

Connaissances

HEDIS

Risk adjustment coding

Provider education

NCQA guidelines

Formation

Bachelor's Degree or equivalent

Description du poste

Centene Corp. is seeking a Quality Practice Advisor to establish and foster productive relationships with large physician practices and IPAs.

The role educates providers on NCQA HEDIS measures, risk adjustment, documentation, and coding to ensure plan compliance with state and federal standards. The position requires significant travel across KY, southern Indiana, Illinois and Tennessee regions and offers flexible remote/hybrid/field options.