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

Are you looking for a job where you can make a difference in the lives of 28 million people? Centene is dedicated to improving the health of our communities, one person at a time. As a national organization, we offer competitive benefits and believe in workplace flexibility, so you can have a fresh perspective on your career.

Position Purpose: In this role, you will build positive relationships with large physician practices, IPAs, and Centene to promote better healthcare outcomes. You will educate providers on the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment, helping them understand the importance of accurate medical record documentation and coding. You will also play a key role in improving plan compliance and developing quality improvement interventions for our providers. Responsibilities: - Advise and educate provider practices and IPAs on HEDIS measures, medical record documentation guidelines, and coding requirements. - Analyze provider performance data to identify areas for improvement and provide coaching to close gaps. - Collaborate with Provider Relations and other teams to enhance provider performance in quality, risk adjustment, and operations. - Identify opportunities where Centene can support specific practice needs. - Cultivate and maintain clinical relationships with providers across different product lines. Requirements: - Bachelor’s degree or equivalent experience. - At least 3 years of experience in HEDIS record collection and risk adjustment coding. - One of the following certifications: CCS, CPC, CBCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ. We Offer: - Flexible work solutions, including remote options and hybrid 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 extensive training and development opportunities. Pay Range: $25.44 - $45.76 per hour (actual pay may vary based on skills, experience, education, and other factors permitted by law). Centene is proud to be an equal opportunity employer that values and celebrates diversity. We welcome applicants from all backgrounds without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by applicable law.