Quality Practice Advisor - #9754666

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



Job Advertisement: Are you ready to make a positive impact on the lives of millions of 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 a flexible work environment that suits your needs **This position is a hybrid role that requires around 50% of local travel in the Las Vegas area. You can also work remotely from home for the remaining time.** Position Purpose: We are looking for someone to build strong relationships between large physician practices, IPAs, and Centene. Your role will involve educating providers and supporting their practice sites on quality measures and risk adjustment. You will provide guidance on proper medical record documentation and coding. Additionally, you will help resolve issues that impact plan compliance and ensure that we meet quality standards set by State and Federal authorities. You will also serve as a resource for your peers on quality measures and coding. Your input will contribute to the development and implementation of quality improvement interventions and audits related to our providers Responsibilities: - Educate and advise provider practices and IPAs on quality measures, medical record documentation guidelines, and coding requirements in line with state, federal, and NCQA guidelines - Analyze and communicate provider performance data, identifying areas for improvement and strategies for closing gaps - Collaborate with Provider Relations and other teams to enhance provider performance in areas of Quality, Risk Adjustment, and Operations - Identify areas where Centene can support specific practice needs - Develop and maintain strong relationships with providers across different product lines Education/Experience: - Bachelor's degree or equivalent - At least 3 years of experience in HEDIS record collection and risk adjustment coding License/Certification: - One of the following certifications required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ Our Comprehensive Benefits Package: - Flexible work options including remote work 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 exceptional training and development opportunities Centene is an equal opportunity employer that values diversity and respects our differences. We believe in providing fair employment opportunities to all qualified applicants, regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by applicable law If you're ready to make a difference and join our team, apply today! Best regards, [Your Name] ------------------------------------------------ Response: Dear [Hiring Manager], I am writing in response to your job advertisement for the position at Centene. I am excited about the opportunity to contribute to improving the health of our communities and positively impact the lives of millions of people Based on the job description, I believe that my skills and experience in HEDIS record collection and risk adjustment make me a strong fit for this role. I have a Bachelor’s degree and more than 3 years of experience in this area. Moreover, I hold the [relevant certification] certification I am impressed by Centene's commitment to providing a flexible work environment and competitive benefits, such as remote work options, paid time off, and comprehensive health insurance coverage for employees and their dependents. I value the opportunities for professional growth and development that Centene offers, including tuition reimbursement and exceptional training programs I am passionate about building strong relationships with providers and helping them improve their performance in quality measures and risk adjustment. I believe that my expertise can contribute to the success of Centene's mission Thank you for considering my application. I am available for an interview at your convenience. I look forward to discussing how my skills and experience align with Centene's goals Sincerely, [Your Name] ------------------------------------------------ Key Points: - Centene is looking for someone to build relationships with physicians and IPAs, educating them on quality measures and risk adjustment - The role involves resolving issues impacting plan compliance and acting as a resource for peers - The ideal candidate has a Bachelor's degree and at least 3 years of experience in HEDIS record collection and risk adjustment - Required certification options include CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, or CPHQ - Centene offers flexible work options, competitive pay, paid time off, comprehensive health insurance, retirement plans, tuition reimbursement, and training opportunities - Centene values diversity and is an equal opportunity employer, providing fair employment opportunities to all qualified applicants.