HEDIS Quality and Audit Analyst

Centene Corporation

. Support enterprise HEDIS quality oversight, audit readiness, and submission execution activities .

Posted 10/14/2026full-timeRemote • Missouri • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in HEDIS quality oversight, NCQA audits, and CMS submission processes, ensuring compliance and accuracy in documentation and deliverables. Proven ability to manage timelines, coordinate cross-functional collaboration, and identify audit-related issues effectively.

Highest-signal resume keywords

HEDIS Quality OversightNCQA Audit ExperienceCMS Submission ManagementAudit Timeline CoordinationQuality Improvement

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

HEDISNCQA AuditsCMS SubmissionsRoadmap PreparationSection 5 DocumentationCAHPSMeasure-Specific EvidencePopulation ValidationAudit Issue IdentificationDocumentation Requirements

Soft Skills

CollaborationCommunicationProblem-SolvingAttention to DetailProcess Improvement

Industry Keywords

HealthcareRegulatory ComplianceQuality AssuranceAudit ReadinessDocumentation Standards

About the role

Key responsibilities & impact

Support enterprise HEDIS quality oversight, audit readiness, and submission execution activities
Support NCQA audits and CMS submissions by ensuring documentation and deliverables are complete, accurate, and audit-ready
Collaborate with Health Plans and cross-functional partners on HEDIS audit and submission timelines and requirements
Contribute to process improvement through documentation of lessons learned and enhancement opportunities
Perform NCQA HEDIS audit activities, including preparation and maintenance of Roadmaps, Section 5 documentation, CAHPS, and measure-specific evidence
Manage audit and submission timelines, deliverables, and dependencies
Collaborate with Health Plans on reporting population validation and measure selection
Oversee CMS submission activities, including PLD coordination and submission tracking
Apply enterprise standards, templates, and documentation requirements across HEDIS audit deliverables
Identify, document, and escalate audit issues, risks, and documentation gaps
Lead and participate in audit meetings, working sessions, and internal stakeholder reviews
Perform quality checks to ensure audit materials are complete, accurate, and defensible
Comply with all policies and standards and perform other duties as assigned

Requirements

What you’ll need

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
Bachelor's Degree in healthcare or a related field or equivalent experience required
2+ years of HEDIS, regulatory, audit, or quality improvement experience, preferably in a healthcare environment required
Knowledge of NCQA HEDIS audits and CMS submissions
Ability to prepare and maintain Roadmaps, Section 5 documentation, CAHPS, and measure-specific evidence
Ability to manage audit and submission timelines, deliverables, and dependencies
Experience with reporting population validation and measure selection activities
Ability to coordinate PLD and track CMS submissions
Ability to apply enterprise standards, templates, and documentation requirements
Ability to identify, document, and escalate audit issues, risks, and documentation gaps

Benefits

Comp & perks

Competitive pay
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
Equal opportunity employer committed to diversity