Quality Practice Advisor

Establish and foster healthy working relationships with large physician practices and IPAs by educating providers on NCQA HEDIS measures, risk adjustment, and appropriate medical record documentation. Assist in resolving deficiencies impacting plan compliance with State and Federal standards while acting as a resource for health plan peers on coding guidelines. Support the development and implementation of quality improvement interventions and audits to improve provider performance in Quality, Risk Adjustment, and Operations. Collect, summarize, trend, and deliver provider quality and risk adjustment performance data to identify opportunities for improvement and gap closure. Collaborate with Provider Relations teams to maintain Quality KPIs and HEDIS Abstraction accuracy rates. Requires 3+ years in HEDIS record collection and risk adjustment, valid driver's license, and ability to travel up to 75% of the time to provider offices in the Central or Eastern IA area.