Establish and maintain strong working relationships with large physician practices, IPAs, and Centene.
Educate provider practices on NCQA HEDIS measures, risk adjustment, appropriate medical record documentation, and coding requirements.
Support provider sites in resolving deficiencies that affect plan compliance with state and federal standards.
Serve as a resource for health plan peers on HEDIS measures, documentation, and coding.
Support the development and implementation of quality improvement interventions and audits for plan providers.
This is a hybrid field-based role with travel up to 75% of the time. Candidates must reside in Texas, with preference for Corpus Christi and surrounding areas.
- Bachelor's degree or equivalent required
- 3+ years of experience in HEDIS record collection and risk adjustment coding
- Must be authorized to work in the U.S. without employment-based visa sponsorship now or in the future
- Ability to travel up to 75% of the time
- Highly preferred licenses/certifications: LVN, RN, CPC, CPC-A, CRC, or CPHQ
- Required certifications/licenses may include CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A, or CBCS
- RHIT may apply for certain state-specific health plan roles
- Competitive pay
- Health insurance
- 401(k) and stock purchase plans
- Tuition reimbursement
- Paid time off and holidays
- Flexible work schedule options, including remote, hybrid, field, or office arrangements where applicable
Location
Corpus Christi, Texas, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago