HEDIS - Quality Practice Advisor

Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

This is a hybrid remote role that meets directly with provider groups based in the Chicago area to discuss HEDIS performance and strategize ways to improve performance, up to 75% travel. Typical daily tasks will include creating/using PowerPoint presentations, creating/exporting reports, and data analysis.

• Establishes and fosters a healthy working relationship between large physician practices, IPAs and Centene.
• Educates providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment.
• Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding.
• Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS and documentation standards.
• Acts as a resource for the health plan peers on HEDIS measures, appropriate medical record documentation and appropriate coding.
• Supports the development and implementation of quality improvement interventions and audits in relation to plan providers.

• Bachelor's Degree or equivalent required
• 3+ years in HEDIS record collection and risk adjustment (coding) required
• One of the following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS

Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.