What are the responsibilities and job description for the Quality Practice Advisor position at Jobs for Humanity?
Company Description
Company Name: Centene Medicare
Job Description
Are you looking for an opportunity to make a difference in the lives of millions of people? Centene is dedicated to improving the health of our communities, one person at a time. As a national organization, we offer competitive benefits and a flexible work environment.
** This role involves local travel in the Las Vegas area for roughly 50% of the time. The remaining time can be worked remotely from home. **
Job Description: This position aims to establish and maintain positive relationships between Centene, large physician practices, and IPAs. You will educate providers on National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment, ensuring they understand proper medical record documentation and coding. Additionally, you will address deficiencies to ensure compliance with State and Federal standards for HEDIS and documentation. As a resource for your peers, you will assist with HEDIS measures, medical record documentation, and coding. You will also support the development and implementation of quality improvement interventions and audits for plan providers.
- Advise and educate provider practices and IPAs on appropriate HEDIS measures, medical record documentation guidelines, and coding requirements.
- Analyze provider quality and risk adjustment performance data to identify areas for improvement and develop strategies.
- Collaborate with Provider Relations and other teams to enhance provider performance in Quality, Risk Adjustment, and Operations.
- Identify opportunities for Centene to provide support to specific practices.
- Build and maintain strong relationships with providers across different product lines.
Requirements: A Bachelor's degree or equivalent is required, along with at least 3 years of experience in HEDIS record collection and risk adjustment (coding).
License/Certification:
One of the following is required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CBCS.
Our Comprehensive Benefits Package: We offer flexible work options, including remote work and hybrid schedules. Enjoy competitive pay, paid time off (including holidays), health insurance for you and your dependents, 401(k) and stock purchase plans, tuition reimbursement, and top-notch training and development opportunities.
Centene is an equal opportunity employer and we value diversity. We welcome applicants from all backgrounds and walks of life. We believe in the power of differences and are committed to creating an inclusive workplace. 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 any other characteristic protected by applicable law.
Your Response: - Yes, I would like to apply for this position! - I have a Bachelor's degree and 3 years of experience in HEDIS record collection and risk adjustment. - I hold one of the required licenses/certifications: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CBCS. - I am excited about the opportunity to improve healthcare and make a difference in people's lives. - I am comfortable with approximately 50% local travel in the Las Vegas area. - I appreciate the flexible work options and comprehensive benefits package offered by Centene. - I believe in the value of diversity and am committed to promoting an inclusive workplace. - I look forward to contributing to the success of Centene and its mission to transform health communities.
