Associate Quality Practice Advisor

3 days ago

ST Louis MO United States Centene Full time

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.

Hybrid Position: Provider visits in the Southern IL area

Position Purpose: Establishes and fosters a healthy working relationship between community physician and small provider practices and WellCare. Educates providers and supports provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. 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.

  • Under general guidance form Senior Quality Practice Advisors and management, educates community physician and small provider practices in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements.
  • Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement.
  • Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters).
  • Assists in delivering provider specific metrics and coaches providers on gap closing opportunities.
  • Assists in identifying specific practice needs where WellCare can provide support.
  • Partners with physicians/physician staff to find ways to encourage member clinical participation in wellness and education.
  • Provides resources and educational opportunities to provider and staff.
  • Captures concerns and issues in action plans as agreed upon with provider.
  • Documents action plans and details of visits and outcomes. Reports critical incidents and information regarding quality of care issues.
  • Communicates with external data sources as needed to gather data necessary to measure identified outcomes.
  • Provides communication such as newsletter articles, member education, outreach interventions and provider education.
  • Supports quality improvement HEDIS and program studies as needed, requesting records from providers, maintaining databases, and researching to identify members' provider encounter history.
  • Ensures that documentation produced and/or processed complies with state regulations and/or accrediting body requirements.
  • Ensures assigned contract/regulatory report content is accurate and that submission adheres to deadline.
  • Enter documentation of findings in identified databases and ensure accuracy in medical records for data collection, DE and reporting.
  • Performs other duties as assigned.
Candidate Education: Required A Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field or equivalent work experience within a managed care environment related to HEDIS record review, quality improvement, medical coding or transferable skill sets that demonstrates the ability to perform the role. Preferred: A Master's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field. Candidate Experience: Required: 1+ year of experience in related HEDIS medical record review or quality improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff OR 2 years medical coding or other transferable experience and skill set combination that demonstrates the ability to learn and perform the level of the position.

A license in one of the following is preferred: Certified Coding Specialist (CCS), Licensed Practical Nurse (LPN), Licensed Master Social Work (LMSW), Licensed Vocational Nurse (LVN), Licensed Mental Health Counselor (LMHC), Licensed Marital and Family Therapist (LMFT), Licensed Certified Social Worker (LCSW), Licensed Registered Nurse (RN), Acute Care Nurse Practitioner (APRN) (ACNP-BC), Other Foreign trained physician/MD, Health Care Quality and Management (HCQM), Certified Healthcare Professional (CHP), Certified Professional in Healthcare Quality (CPHQ).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.

  • Associate Quality Practice Advisor

    1 month ago

    St Louis, United States Centene Corporation Full time

    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. Hybrid Position: Provider visits in the Southern IL area Position...

  • Associate Quality Practice Advisor

    4 weeks ago

    St Louis, United States Centene Corporation Full time

    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. Hybrid Position: Provider visits in the Southern IL area Position...

  • Associate Financial Advisor

    9 hours ago

    St Louis, United States Edward Jones Full time

    Client advocate. Skilled communicator. Problem solver. Does that describe you? If so, we need you on our team. At Edward Jones, we're all about making a difference. In the lives of our clients - and our people. Our licensed branch associates are highly visible members of the client team, working under the leadership of a financial advisor. You thrive in an...

  • Financial Advisor

    1 month ago

    St Louis, Missouri, United States LPL Financial Full time

    Your career path should lead to real opportunity LPL Financial partners with banks to offer a complete menu of financial services to bank clients. This employment opportunity at Simmons Bank in St. Louis, MO would allow you to join the Investment Program at Simmons Bank as a Financial Advisor associated with LPL Financial. Under this model Financial Advisors...

  • Financial Advisor

    4 weeks ago

    St Louis, Missouri, United States LPL Financial Full time

    Your career path should lead to real opportunity LPL Financial partners with banks to offer a complete menu of financial services to bank clients. This employment opportunity at Simmons Bank in St. Louis, MO would allow you to join the Investment Program at Simmons Bank as a Financial Advisor associated with LPL Financial. Under this model Financial Advisors...

  • Experienced Advisor Onboarding Specialist

    2 weeks ago

    St Louis, United States Edward Jones Full time

    Want a meaningful career where you can make a difference? Edward Jones sounds perfect for you.Collaboration. Autonomy. Opportunity. Words our headquarters associates use when talking about working at Edward Jones. Words that describe what it's like being part of a firm where everyone is aligned toward a singular focus: serving the client. And everyone is...

  • Experienced Advisor Onboarding Specialist

    3 weeks ago

    St Louis, United States Edward Jones Full time

    Want a meaningful career where you can make a difference? Edward Jones sounds perfect for you. Collaboration. Autonomy. Opportunity. Words our headquarters associates use when talking about working at Edward Jones. Words that describe what it's like being part of a firm where everyone is aligned toward a singular focus: serving the client. And everyone is...

  • Quality Practice Advisor

    4 weeks ago

    Indianapolis, IN, United States Managed Health Services Indiana Full time

    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 Purpose: Establishes and fosters a healthy working...

  • Client Advisor

    2 months ago

    St. Louis, United States Marsh McLennan Companies Full time

    Description: Marsh is seeking candidates for the following position in our Central Zone. Client Advisor - Construction What can you expect? The Client Advisor will act as a Program Manager in the Southcentral zone. This role provides specific advice, service, and solution delivery to clients and prospects in regards to their program...

  • Client Advisor

    4 weeks ago

    St. Louis, United States Marsh McLennan Companies Full time

    Description: Marsh is seeking candidates for the following position in our Central Zone. Client Advisor - Construction What can you expect? The Client Advisor will act as a Program Manager in the Southcentral zone. This role provides specific advice, service, and solution delivery to clients and prospects in regards to their program...

  • Client Advisor

    4 weeks ago

    St Louis, United States LVMH Full time

    Poste Our Louis Vuitton Saint Louis location is seeking a highly motivated Part-Time Client Advisor with a passion for creating memorable experiences for our worldly clientele. We are ideally seeking candidates in the Saint Louis market with flexible availability to work 20-29 hours per week, based on business needs. This temporary position is designed to...

  • Client Advisor

    4 weeks ago

    St Louis, United States LVMH Full time

    Poste Our Louis Vuitton Saint Louis location is seeking a highly motivated Part-Time Client Advisor with a passion for creating memorable experiences for our worldly clientele. We are ideally seeking candidates in the Saint Louis market with flexible availability to work 20-29 hours per week, based on business needs. This temporary position is designed to...

  • Quality Practice Advisor

    3 weeks ago

    El Paso, TX, United States Superior HealthPlan Full time

    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. Must Reside in the State of TexasService Area: Odessa and Midland TX...

  • Client Service Associate- St. Louis, MO

    2 weeks ago

    St Louis, United States Raymond James Financial Incorporated Full time

    Job SummaryCelebrating more than 60 years of rich history and recognition for service and excellence in the Financial Services industry, Raymond James is seeking a dynamic Client Service Associate who is a motivated, detail oriented and creative problem solver to join our growing team. This essential role helps to provide high quality/high touch critical...

  • Software Engineering Senior Advisor-Hybrid

    3 weeks ago

    St Louis, Missouri, United States The Cigna Group Full time

    The job profile for this position is Software Engineering Senior Advisor, which is a Band 4 Senior Contributor Career Track Role.Excited to grow your career?We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see...

  • Experience Advisor Onboarding Specialist

    4 weeks ago

    St Louis, United States Edward Jones Full time

    EDWARD JONES Experience Advisor Onboarding Specialist - 92795BR St. Louis , Missouri Apply Now The Experienced Advisor Onboarding Specialist will provide on-site dedicated onboarding support for Experienced Financial Advisors and Emerging Producers to ensure an ideal client transition and the new recruits are given the opportunity to experience what Edward...

  • Experience Advisor Onboarding Specialist

    4 weeks ago

    St Louis, United States Edward Jones Full time

    EDWARD JONES Experience Advisor Onboarding Specialist - 92795BR St. Louis , Missouri Apply Now The Experienced Advisor Onboarding Specialist will provide on-site dedicated onboarding support for Experienced Financial Advisors and Emerging Producers to ensure an ideal client transition and the new recruits are given the opportunity to experience what Edward...

  • Academic Advisor

    1 month ago

    St Louis, Missouri, United States Villa Duchesne Full time

    Villa Duchesne is seeking a part-time Academic Advisor for our Upper School (Grades This position requires that the candidate have a bachelor's degree and relevant experience advising young people about finding their passion in life and building an educational pathway to meet their goals. This position will work primarily with 9th and 10th grade families...

  • Academic Advisor

    4 weeks ago

    St Louis, Missouri, United States Villa Duchesne Full time

    Villa Duchesne is seeking a part-time Academic Advisor for our Upper School (Grades This position requires that the candidate have a bachelor's degree and relevant experience advising young people about finding their passion in life and building an educational pathway to meet their goals. This position will work primarily with 9th and 10th grade families...

  • Senior Financial Advisor

    4 weeks ago

    St Louis, United States Farther LLC Full time

    Job Description Job Description Company Description Farther is a rapidly growing RIA that combines expert advisors with cutting-edge technology - delivering a comprehensive, tailored wealth management experience. Farther's founders are leaders and innovators from the private wealth industry who possess a unique blend of traditional wealth management,...