Associate Quality Practice Advisor
Core
Educates and supports physician and small provider practices on NCQA HEDIS measures, medical record documentation, and coding to ensure plan compliance with State and Federal standards.
Role type
Associate Quality Practice Advisor (Provider Relations)
Builds
Provider performance improvement strategies and compliance with quality metrics
Domain
Healthcare / Managed Care / Quality Improvement
Deliverable
dashboards & analysis
Required skills
HEDIS measures knowledge, medical record review, medical coding (ICD-9/10, CPT), data analysis, provider education, regulatory compliance
Preferred skills
Master's degree in Healthcare/Public Health/Nursing, CCS, LPN, LMSW, LCSW, RN, CPHQ, CHP
Technologies
Databases, NCQA HEDIS tools
Responsibilities
Educate providers on HEDIS and coding guidelines, collect and trend provider performance data, coach providers on gap closing, document action plans and visit outcomes, report critical incidents, maintain databases for data collection and reporting, ensure documentation complies with state regulations.
Seniority
Associate, entry-level IC
