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.
This is a remote position . The ideal candidate will be an LPN or RN (compact license) with experience in HEDIS measures, provider education, and risk adjustment.
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.
- Maintains Quality KPI and maintains good standing with HEDIS Abstraction accuracy rates as per corporate standards.
- Ability to travel up to 75% of time to provider offices.
- Performs other duties as assigned.
- Complies with all policies and standards.
Education/Experience:
Bachelor's Degree or equivalent required
3+ years in HEDIS record collection and risk adjustment (coding) required
Licenses/Certifications:
One of the following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS
Pay Range: $27.02 - $48.55 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
About the Quality Practice Advisor, LPN, RN Opportunity
Centene Corporation is currently hiring for a Quality Practice Advisor, LPN, RN position based in Remote-OK, Oklahoma, United States of America. This is a full time opportunity suited to candidates who are ready to contribute their skills and grow within a dynamic team environment. Whether you're an experienced professional or looking to take the next step in your career, this role offers a chance to work on meaningful projects while developing new capabilities.
What the Role Involves
As a Quality Practice Advisor, LPN, RN, you will be expected to collaborate closely with cross-functional teams, take ownership of key deliverables, and contribute ideas that help Centene Corporation achieve its goals. Day-to-day responsibilities typically include planning and prioritizing tasks, communicating progress with stakeholders, maintaining high standards of quality, and adapting to evolving business needs. The exact scope of duties may vary depending on team structure and current priorities, so candidates should be comfortable with a role that can evolve over time.
Who Centene Corporation is Looking For
Successful candidates generally bring a combination of relevant experience, strong communication skills, and a proactive attitude toward problem-solving. Centene Corporation values individuals who can work independently as well as part of a team, who are detail-oriented, and who bring a positive, adaptable mindset to their work. Prior experience in a similar Quality Practice Advisor, LPN, RN capacity is beneficial, though a strong willingness to learn and grow is equally important.
This position sits within the Administrative & Claims Operations space, so familiarity with the trends, tools, and standards common to that industry can be an advantage, though it is not always a strict requirement.
Compensation and Benefits
Compensation for this role is competitive and commensurate with experience. In addition to base pay, many roles at Centene Corporation may include benefits such as health coverage, paid time off, opportunities for professional development, and a supportive work culture designed to help employees thrive both personally and professionally.
Why Join Centene Corporation?
Joining Centene Corporation as a Quality Practice Advisor, LPN, RN means becoming part of a team that values collaboration, innovation, and continuous improvement. Employees are encouraged to bring their own perspective to the table, and the organization aims to foster an environment where people feel supported in doing their best work. This is a great opportunity for candidates who want their contributions to have a real, visible impact.
How to Apply
If you believe you're a strong fit for the Quality Practice Advisor, LPN, RN role at Centene Corporation in Remote-OK, Oklahoma, United States of America, we encourage you to review the full job details above and submit your application through the listed channel. This position was posted on 2026-06-03. Early applications are generally encouraged, as competitive roles like this one can attract a high volume of interest.
