Advisor

• 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, documentation and coding
• Support development and implementation of quality improvement interventions and provider-related audits
• Deliver, 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 to identify provider improvement and gap-closure opportunities
• 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 duties as assigned and comply with all policies and standards

Advisor jobs in Kentucky

Quality Practice Advisor