Quality Practice Advisor

Centene Corporation

. Establish and foster healthy working relationships between large physician practices, IPAs, and Centene .

Posted 11/3/2026full-timeRemote • California • United StatesMid-LevelSenior💰 $27 - $49 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in HEDIS measures, risk adjustment coding, and medical record documentation while fostering strong relationships with healthcare providers. Capable of analyzing performance data and implementing quality improvement strategies to enhance compliance and operational efficiency.

Highest-signal resume keywords

HEDIS Record CollectionRisk Adjustment CodingNCQA HEDIS MeasuresMedical Record DocumentationQuality Improvement Interventions

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

ICD-9 CodingICD-10 CodingCPT CodingData AnalysisQuality KPI Maintenance

Soft Skills

Relationship BuildingCoachingCollaborationEducationCommunication

Certifications & Qualifications

CCSLPNLCSWLMHCLMSWLMFTLVNRNAPRNRHIT

Industry Keywords

HEDISNCQARisk AdjustmentProvider RelationsCompliance Standards

About the role

Key responsibilities & impact

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, medical record documentation, and appropriate coding
Assist in resolving deficiencies affecting plan compliance with State and Federal HEDIS and documentation standards
Serve as a resource for health plan peers on HEDIS measures, medical record documentation, and coding
Support development and implementation of quality improvement interventions and provider-related audits
Advise and educate provider practices and IPAs on HEDIS measures, documentation guidelines, and HEDIS ICD-9/10 CPT coding
Collect, summarize, trend, and deliver provider quality and risk adjustment performance data
Identify and strategize or coach on provider improvement opportunities and gap closure
Collaborate with Provider Relations and other provider-facing teams to improve Quality, Risk Adjustment, and Operations performance
Identify practice needs where Centene can provide support
Develop, enhance, and maintain provider clinical relationships across product lines
Maintain Quality KPIs and HEDIS abstraction accuracy rates according to corporate standards
Perform other assigned duties
Comply with all policies and standards

Requirements

What you’ll need

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
Ability to travel up to 75% of time to provider offices
For IL Health Plan only: Must reside in IL or within a reasonable driving distance to assigned providers
Knowledge of National Committee for Quality Assurance (NCQA) HEDIS measures, risk adjustment, medical record documentation, and ICD-9/10 CPT coding
For certain plans, license/certification requirements vary, including preferred, not required, or not required statuses

Benefits

Comp & perks

Health insurance
401K
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 employment
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act