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Centene Corporation
Columbus, OH, United States
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, youll have access to competitive benefits including a fresh perspective on workplace flexibility. *****Position is REMOTE but candidate must reside in State of
Job Source: Centene CorporationCentene Corporation
Groveport, OH, United States
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, youll have access to competitive benefits including a fresh perspective on workplace flexibility. ***Position is REMOTE but candidate must reside in State of O
Job Source: Centene CorporationHumana
Columbus
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Job Source: HumanaCBRE
Columbus
Ad-Hoc Project Advisor Job ID 167735 Posted 19-Jun-2024 Service line Advisory Segment Role type Part-time Areas of Interest Sales Support Location(s) Denver - Colorado - United States of America, Remote - US - Remote - US - United States of America About the role Provides general administrative and marketing support to a group of sales professional
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Job Source: MarketSourceRenaissance
Columbus
When you join Renaissance®, you join a global leader in pre-K–12 education technology. Renaissance’s solutions help educators analyze, customize, and plan personalized learning paths for students, allowing time for what matters—creating energizing learning experiences in the classroom. Our fiercely passionate employees and educational partners have
Job Source: RenaissanceSedgwick
Columbus
Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support
Job Source: SedgwickHumana
Columbus
**Become a part of our caring community and help us put health first** The Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The Market Development A
Job Source: HumanaColumbus
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.
Position is REMOTE but candidate must reside in State of OHIO
**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.
+ Performs other duties as assigned
+ Complies with all policies and standards
**Education/Experience:** Bachelor’s degree or equivalent required. 3+ years of experience in HEDIS record collection and risk adjustment (coding).
**License/Certification:**
**One of the following required:** CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CBCS.
**For Buckeye Health Plan** -- No license/certification is required.
Pay Range: $25.97 - $46.68 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.
Email Alert for Quality Practice Advisor_ jobs in Columbus
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