Jobs for Humanity is partnering with Centene Medicare to build an inclusive and just employment ecosystem. Therefore, we prioritize individuals coming from the following communities: Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Deaf or Hard of Hearing, Black, Hispanic, Asian, Military Veterans, the Elderly, the LGBTQ, and Justice Impacted individuals. This position is open to candidates who reside in and have the legal right to work in the country where the job is located.

Company Name: Centene Medicare

You have the power to make a difference in the lives of our 28 million members. At Centene, we are dedicated to improving the health of our communities, one person at a time. As a national organization that values diversity, we offer competitive benefits and a flexible work environment.

Position Purpose: We are looking for someone who can build strong relationships with large physician practices, IPAs, and Centene. Your role will involve educating providers and supporting their practice sites in meeting quality standards. This includes providing guidance on HEDIS measures, medical record documentation, and coding. You will also help address any deficiencies that impact plan compliance with state and federal standards. Your expertise will be a valuable resource for your colleagues, and you will contribute to developing and implementing quality improvement interventions and audits. You will: - Educate provider practices and IPAs on HEDIS measures, medical record documentation guidelines, and coding requirements. - Analyze provider quality and risk adjustment performance data to identify areas for improvement and provide coaching. - Collaborate with Provider Relations and other teams to enhance provider performance in areas of Quality, Risk Adjustment, and Operations. - Identify specific needs of practices where Centene can offer support. - Foster provider relationships across different product lines. Education/Experience: A bachelor's degree or equivalent is required for this role. You should also have at least 3 years of experience in HEDIS record collection and risk adjustment coding. License/Certification: One of the following certifications is required: CCS, CPC, CBCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, or CPHQ. We offer a comprehensive benefits package, including: - Flexible work solutions, such as remote options and hybrid work schedules. - Competitive pay. - Paid time off, including holidays. - Health insurance coverage for you and your dependents. - 401(k) and stock purchase plans. - Tuition reimbursement and opportunities for training and development. At Centene, we embrace diversity and value our differences. We are an equal opportunity employer and encourage applications from individuals of all backgrounds, including elderly individuals, refugees, people with disabilities (both visible and invisible), LGBTQIA+ individuals, veterans, and more. If this sounds like the opportunity for you, please submit your application using the form below. We look forward to hearing from you.