Quality Practice Advisor

🕒 June 25

🐎 Kentucky – Remote

🐎 Kentucky – Remote

💵 $27 - $48 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 45%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

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

• Establish and foster healthy working relationships between large physician practices, IPAs and Centene • Educate providers and support provider practice sites regarding NCQA HEDIS measures and risk adjustment • Provide education on HEDIS measures, appropriate medical record documentation and appropriate coding • Assist in resolving deficiencies impacting plan compliance with State and Federal HEDIS and documentation standards • Act as a resource for health plan peers on HEDIS measures, medical record documentation and coding • Support development and implementation of quality improvement interventions and audits related to plan providers • Travel 50% across Region 1, including Paducah, Kentucky; south Evansville to the Tennessee line; North Indiana; Illinois through Kentucky; and Mayfield to Hopkinsville

🎯 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®) • State requirements apply for positions aligned to a corporate line of business operating within a state-specific health plan • For the Kentucky plan only, CADC and the listed licenses/certifications are preferred but not required, with 3 years HEDIS experience

🏖️ Benefits

• Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation