Quality Practice Advisor
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Before you apply
Salary$27 – $49/hr
LocationRemote-NV
Work moderemote · United States
Typefull-time
SeniorityMid
Experience3+ yrs
EquityIncluded
Company size10,000+ people
PostedSep 25, 2026 · 1mo ago
Verified live2d ago
At a glanceSummarised by Seekless from the posting.
Bachelor's Degree or equivalent required
3+ years in HEDIS record collection and risk adjustment (coding) required
One of the following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS
Provider experience preferred
HEDIS knowledge preferred
Medical coding experience preferred
Quality improvement experience preferred
Health plan experience preferred
Candidates must reside in Nevada
Occasional travel required
Benefits
Health insurance
401(k)
Stock purchase plans
Tuition reimbursement
Paid time off
Remote flexible work
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.
Requirements
Key Details: Candidates must reside in Nevada, as this position requires occasional travel. One of the following active licenses or certifications is required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A, or CBCS. Preferred qualifications include provider experience, HEDIS knowledge, medical coding experience, quality improvement experience, and health plan experience.
Responsibilities
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Delivers, 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.
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Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and strategize/coach on opportunities for provider improvement and gap closure.
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Collaborates with Provider Relations and other provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters).
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Identifies specific practice needs where Centene can provide support.
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Develops, enhances and maintains provider clinical relationship across product lines.
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Maintains Quality KPI and maintains good standing with HEDIS Abstraction accuracy rates as per corporate standards.
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Ability to travel up to 75% of time to provider offices.
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Performs other duties as assigned.
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Complies with all policies and standards.
Education/Experience:
Bachelor’s Degree or equivalent required
3+ years in HEDIS record collection and risk adjustment (coding) required
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
About the company
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Benefits
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.
Legal
Centene 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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act