Quality Practice Advisor

🕒 4 days ago

🌽 Illinois, Kentucky – Remote

🌽 Illinois – Remote 🐎 Kentucky – Remote

💵 $27 - $48 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

Apply Now

Find Similar Remote Jobs

Receive Emails For Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

Healthcare Insurance • Non-profit • Social Impact

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• 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.

🎯 Requirements

• 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 Registered Health Information Technician (RHIT®) • For positions aligned to a corporate line of business that report into and operate within a state specific health plan, state requirements apply • For the Kentucky plan only: License/Certification preferred, not required: CADC, CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A, or CBCS, + 3 years HEDIS experience

🏖️ Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules