You are a healthcare professional with at least three years of experience in HEDIS record collection and risk adjustment. You hold a Bachelor’s degree and a cli
Work type: remote
Location: Remote-NC
Salary: $27 – $49/hr
Type: Full-time
You are a healthcare professional with at least three years of experience in HEDIS record collection and risk adjustment. You hold a Bachelor’s degree and a clinical certification like an RN, CPC, or LPN, and you reside in North Carolina. **What makes it worth a look...** Centene offers a pay range of $27.02 to $48.55 per hour for this remote role. While the position is remote-based in North Carolina, you must be prepared for up to 75% travel to local provider offices for medical record retrieval and engagement. **You might be a good fit if you...** * Have hands-on experience with HEDIS measures and ICD-9/10 coding. * Can interpret and deliver complex quality performance data to physician practices. * Are comfortable performing clinical audits and managing medical documentation reviews. * Possess an active nursing or medical coding certification.
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 including a fresh perspective on workplace flexibility.
Job Description
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPTQualified applicants must reside in North Carolina. Travel is required for in-person provider engagement, meetings, and medical record retrieval, so the amount of travel will vary based on need. RN highly preferred
Position Purpose:
Establishes and fosters a healthy working relationship between large physician practices, IPAs and Centene. Educates providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for the health plan peers on HEDIS measures, appropriate medical record documentation and appropriate coding. Supports the development and implementation of quality improvement interventions and audits in relation to plan providers.
Licenses/Certifications:
One of the following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS
Pay Range: $27.02 - $48.55 per hour
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K 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.