HEDIS Quality and Audit Analyst

Centene Corporation • Remote-MO, MO

3d

About The Position

The HEDIS Quality and Audit Analyst supports enterprise HEDIS quality oversight, audit readiness, and submission execution. The role applies established standards, processes, and regulatory requirements to support NCQA audits and CMS submissions, ensuring documentation and deliverables are complete, accurate, and audit-ready. The Analyst collaborates with Health Plans and cross-functional partners to meet HEDIS audit and submission timelines and requirements.

Requirements

• Bachelor’s degree in healthcare or a related field, or equivalent experience.
• At least 2 years of HEDIS, regulatory, audit, or quality improvement experience; preferably in a healthcare environment.

Responsibilities

• Support HEDIS quality oversight, audit readiness, and submission activities.
• Contribute to process improvement by documenting lessons learned and enhancement opportunities.
• Perform NCQA HEDIS audit activities, including preparing and maintaining Roadmaps, Section 5 documentation, and CAHPS- and measure-specific evidence.
• Manage audit and submission timelines, deliverables, and dependencies.
• Collaborate with Health Plans on reporting population validation and measure selection activities.
• Oversee CMS submission activities, including PLD coordination and submission tracking.
• Apply enterprise standards, templates, and documentation requirements across HEDIS audit deliverables.
• Identify, document, and escalate audit issues, risks, and documentation gaps.
• Lead and participate in audit meetings, working sessions, and internal stakeholder reviews.
• Perform quality checks to ensure audit materials are complete, accurate, and defensible.
• Perform other duties as assigned.
• Comply with all policies and standards.

Benefits

• Competitive pay
• Health insurance
• 401(k) and stock purchase plans
• Tuition reimbursement
• Paid time off and holidays
• Flexible approach to work, with remote, hybrid, field, or office schedules

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level