? 3 Days Left! Quality Practice Advisor
Company: Oklahoma Complete Health
Location: Oklahoma City
Posted on: June 25, 2025
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Job 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. THIS POSITION IS REMOTE/WORK FROM HOME.
PREFER APPLICANTS WHO RESIDEIN THE STATE OF OKLAHOMA. WILL TRAVEL
10% TO DO PERIODIC PROVIDER OFFICE VISITS IF RESIDES IN OKLAHOMA.
THIS ROLE IS SUPPORTING OUR OKLAHOMA COMPLETE HEALTH PLAN. THE WORK
SCHEDULE IS MONDAY - FRIDAY, 8AM - 5PM CENTRAL TIME ZONE. IDEAL
APPLICANT WILL BE A NURSE WITH HEDIS BACKGROUND. 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. - 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. -
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. -
Collaborates with Provider Relations and other provider facing
teams to improve provider performance in areas of Quality, Risk
Adjustment and Operations (claims and encounters). - Identifies
specific practice needs where Centene can provide support. -
Develops, enhances and maintains provider clinical relationship
across product lines. - Maintains Quality KPI and maintains good
standing with HEDIS Abstraction accuracy rates as per corporate
standards. - Ability to travel up to 10% of time to provider
offices. - Performs other duties as assigned - 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 One of the following required: CCS,
LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC,
CBCS required Pay Range: $26.50 - $47.59 per hour 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. Total compensation
may also include additional forms of incentives. 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
Keywords: Oklahoma Complete Health, Midwest City , ? 3 Days Left! Quality Practice Advisor, Healthcare , Oklahoma City, Oklahoma
