Ideal for a professional with at least four years of experience in HEDIS, quality audits, or regulated healthcare environments. You need a bachelor’s degree in
Work type: remote
Location: Remote-TX
Salary: $70,100 – $126,200/yr
Type: Full-time
Ideal for a professional with at least four years of experience in HEDIS, quality audits, or regulated healthcare environments. You need a bachelor’s degree in healthcare or a related field to qualify for this senior-level position. **What makes it worth a look...** Centene offers a salary range of $70,100 to $126,200 per year for this fully remote role based in the United States. You will have access to comprehensive benefits including 401K plans and tuition reimbursement. **You might be a good fit if you...** * Have led complex NCQA audit workstreams and documentation. * Can interpret and apply federal and state regulatory requirements. * Possess experience with CMS submission activities and PLD coordination. * Hold a master’s degree in a healthcare field or have specific LTSS experience.
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.
*Applicants for this job have the flexibility to work remote from home anywhere in the United States.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 CPT.Position Purpose:
The Senior HEDIS Quality & Audit Analyst serves as an enterprise subject matter expert responsible for advanced HEDIS quality oversight, audit readiness, and submission support activities. This role independently interprets regulatory and audit requirements, leads complex HEDIS audit workstreams, and ensures accurate, timely, and audit-defensible documentation and submissions in alignment with NCQA and CMS expectations.
Operating with a high degree of autonomy, the Senior Analyst provides expert guidance on audit risk, regulatory interpretation, and submission requirements while partnering with Health Plans, National and State Auditors, IT, Analytics, and Quality stakeholders.
Pay Range: $70,100.00 - $126,200.00 per year
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.