{"schemaVersion":"jobsearcher.job.v1","id":"f89d4e4feea2ec38dfd83790","url":"https://jobsearcher.com/jobs/f89d4e4feea2ec38dfd83790","canonicalUrl":"https://jobsearcher.com/jobs/f89d4e4feea2ec38dfd83790","title":"HEDIS - Quality Practice Advisor","description":"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.\n\n****NOTE: This is a hybrid remote role that meets directly with provider groups based in the Chicago area to discuss HEDIS performance and strategize ways to improve performance, up to 75% travel. Typical daily tasks will include creating/using PowerPoint presentations, creating/exporting reports, and data analysis.\nAdditional Details:\n\nDepartment: Quality Improvement\nBusiness Unit: Illinois Health Plan\nSchedule: Mon – Fri, 8am – 4:30 pm CT\nTerritory: Cook, DuPage, Will, Lake County, Illinois. Work-from-home but requires travel to conduct in-person provider visits, including quarterly in-person team meetings in Burr Ridge, IL office. Must reside in IL and in the above counties.****\nPosition 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.\nDelivers, advises and educates provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with state, federal, and NCQA requirements.\nCollects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and strategize/coach on opportunities for provider improvement and gap closure.\nCollaborates with Provider Relations and other provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters).\nIdentifies specific practice needs where Centene can provide support.\nDevelops, enhances and maintains provider clinical relationship across product lines.\nMaintains Quality KPI and maintains good standing with HEDIS Abstraction accuracy rates as per corporate standards.\nAbility to travel up to 75% of time to provider offices.\nPerforms other duties as assigned.\nComplies with all policies and standards.\n\nEducation/Experience:\nBachelor's Degree or equivalent required\n3+ years in HEDIS record collection and risk adjustment (coding) required\n\nLicenses/Certifications:\nOne of the following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS\n\nFor IL Health Plan only: Must reside in IL or within a reasonable driving distance to assigned providers.\nPay Range: $26.50 - $47.59 per hour\nCentene 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.\nCentene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.\n\nQualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act","company":"Centene","rawCompany":"centene","city":"Roselle","state":"IL","isRemote":false,"isActive":false,"createdAt":"2026-06-16T09:49:32.054Z","occupations":[{"code":"29-9021.00","title":"Health Information Technologists and Medical Registrars","slug":"health-information-technologists-and-medical-registrars"},{"code":"15-1211.01","title":"Health Informatics Specialists","slug":"health-informatics-specialists"},{"code":"13-2053.00","title":"Insurance Underwriters","slug":"insurance-underwriters"}],"industries":[{"code":"524298","title":"All Other Insurance Related Activities","slug":"all-other-insurance-related-activities"},{"code":"621999","title":"All Other Miscellaneous Ambulatory Health Care Services","slug":"all-other-miscellaneous-ambulatory-health-care-services"},{"code":"621498","title":"All Other Outpatient Care Centers","slug":"all-other-outpatient-care-centers"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"HEDIS - Quality Practice Advisor","description":"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.\n\n****NOTE: This is a hybrid remote role that meets directly with provider groups based in the Chicago area to discuss HEDIS performance and strategize ways to improve performance, up to 75% travel. Typical daily tasks will include creating/using PowerPoint presentations, creating/exporting reports, and data analysis.\nAdditional Details:\n\nDepartment: Quality Improvement\nBusiness Unit: Illinois Health Plan\nSchedule: Mon – Fri, 8am – 4:30 pm CT\nTerritory: Cook, DuPage, Will, Lake County, Illinois. Work-from-home but requires travel to conduct in-person provider visits, including quarterly in-person team meetings in Burr Ridge, IL office. Must reside in IL and in the above counties.****\nPosition 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.\nDelivers, advises and educates provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with state, federal, and NCQA requirements.\nCollects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and strategize/coach on opportunities for provider improvement and gap closure.\nCollaborates with Provider Relations and other provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters).\nIdentifies specific practice needs where Centene can provide support.\nDevelops, enhances and maintains provider clinical relationship across product lines.\nMaintains Quality KPI and maintains good standing with HEDIS Abstraction accuracy rates as per corporate standards.\nAbility to travel up to 75% of time to provider offices.\nPerforms other duties as assigned.\nComplies with all policies and standards.\n\nEducation/Experience:\nBachelor's Degree or equivalent required\n3+ years in HEDIS record collection and risk adjustment (coding) required\n\nLicenses/Certifications:\nOne of the following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS\n\nFor IL Health Plan only: Must reside in IL or within a reasonable driving distance to assigned providers.\nPay Range: $26.50 - $47.59 per hour\nCentene 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.\nCentene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.\n\nQualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act","datePosted":"2026-06-16T09:49:32.054Z","dateModified":"2026-06-16T09:49:32.054Z","hiringOrganization":{"@type":"Organization","name":"Centene","sameAs":"https://jobsearcher.com"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Roselle","addressRegion":"IL","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"f89d4e4feea2ec38dfd83790"},"url":"https://jobsearcher.com/jobs/f89d4e4feea2ec38dfd83790"}}