Job Description

Centene is looking for someone who can make a positive impact on our 28 million members. We are committed to improving the health of our communities, one person at a time. As a national organization, we offer competitive benefits and value workplace flexibility.

Position Purpose:

This role focuses on building good relationships between large physician practices, IPAs, and Centene. You will educate providers and support their practice sites on the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Your expertise in HEDIS measures, medical record documentation, and coding will help ensure compliance with state and federal standards. You will also assist in quality improvement interventions and audits to benefit our plan providers.

Key Responsibilities:

• Deliver education and advice to provider practices and IPAs on HEDIS measures, medical record documentation guidelines, and coding requirements.
• Analyze provider performance data to identify improvement opportunities and provide coaching.
• Collaborate with Provider Relations and other teams to enhance provider performance in areas of Quality, Risk Adjustment, and Operations.
• Identify areas where Centene can offer support to specific practices.
• Build and maintain positive relationships with providers across product lines.

Education/Experience:

We require a Bachelor's degree or equivalent. You should have at least 3 years of experience in HEDIS record collection and risk adjustment (coding).

License/Certification:

You must have one of the following certifications: CCS, CPC, CBCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ.

Our Comprehensive Benefits Package includes:

• Flexible work solutions, including remote options and hybrid schedules
• Competitive pay
• Paid time off, including holidays
• Health insurance coverage for you and your dependents
• 401(k) and stock purchase plans
• Tuition reimbursement and training opportunities

Pay Range: $25.44 - $45.76 per hour

Actual pay may vary based on skills, experience, education, and other job-related factors.

Centene is committed to diversity and values the unique contributions of our employees. We are an equal opportunity employer, and 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 legally protected characteristics.