PA Health & Wellness
You could be the one who changes everything for our 28 million members. 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 and a fresh perspective on workplace flexibility.
Position Purpose Establishes and fosters a healthy working relationship between large physician practices, IPAs and Centene. Educates providers and supports provider practice sites regarding NCQA HEDIS measures, risk adjustment, and medical record documentation.
Responsibilities
Deliver, advise and educate provider practices and IPAs on HEDIS measures, medical record documentation guidelines and HEDIS ICD‑9/10 CPT coding in accordance with state, federal and NCQA requirements.
Collect, summarize, trend and deliver provider quality and risk adjustment performance data to identify and coach on opportunities for provider improvement.
Collaborate with Provider Relations and other provider‑facing teams to improve provider performance in Quality, Risk Adjustment and Operations (claims and encounters).
Identify specific practice needs where Centene can provide support.
Develop, enhance and maintain provider clinical relationships across product lines.
Maintain Quality KPI and maintain good standing with HEDIS abstraction accuracy rates as per corporate standards.
Travel 50% of time to provider offices.
Perform other duties as assigned.
Comply with all policies and standards.
Education & Experience
Bachelor’s Degree or equivalent required.
3+ years in HEDIS record collection and risk adjustment (coding) required.
Licenses / Certifications
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®) acceptable.
For Managed Health Services – IN – no license/certification required.
Location & Travel
Must reside in the state of Indiana.
Position requires 50% local travel to provider practice sites.
Must be authorized to work in the U.S. without the need for employment‑based visa sponsorship now or in the future.
Pay Range $27.02 – $48.55 per hour.
Benefits Competitive pay, health insurance, 401(k) 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. Actual pay will be adjusted based on an individual's skills, experience, education and other job‑related factors permitted by law, including full‑time or part‑time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Equal Opportunity Statement 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. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.
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Position Purpose Establishes and fosters a healthy working relationship between large physician practices, IPAs and Centene. Educates providers and supports provider practice sites regarding NCQA HEDIS measures, risk adjustment, and medical record documentation.
Responsibilities
Deliver, advise and educate provider practices and IPAs on HEDIS measures, medical record documentation guidelines and HEDIS ICD‑9/10 CPT coding in accordance with state, federal and NCQA requirements.
Collect, summarize, trend and deliver provider quality and risk adjustment performance data to identify and coach on opportunities for provider improvement.
Collaborate with Provider Relations and other provider‑facing teams to improve provider performance in Quality, Risk Adjustment and Operations (claims and encounters).
Identify specific practice needs where Centene can provide support.
Develop, enhance and maintain provider clinical relationships across product lines.
Maintain Quality KPI and maintain good standing with HEDIS abstraction accuracy rates as per corporate standards.
Travel 50% of time to provider offices.
Perform other duties as assigned.
Comply with all policies and standards.
Education & Experience
Bachelor’s Degree or equivalent required.
3+ years in HEDIS record collection and risk adjustment (coding) required.
Licenses / Certifications
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®) acceptable.
For Managed Health Services – IN – no license/certification required.
Location & Travel
Must reside in the state of Indiana.
Position requires 50% local travel to provider practice sites.
Must be authorized to work in the U.S. without the need for employment‑based visa sponsorship now or in the future.
Pay Range $27.02 – $48.55 per hour.
Benefits Competitive pay, health insurance, 401(k) 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. Actual pay will be adjusted based on an individual's skills, experience, education and other job‑related factors permitted by law, including full‑time or part‑time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Equal Opportunity Statement 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. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.
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