HEDIS Quality and Audit Analyst

Centene Corporation•Remote-MO, MO

2d•Remote

About The Position

The HEDIS Quality & Audit Analyst supports enterprise HEDIS quality oversight, audit readiness, and submission execution activities. This 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 works collaboratively with Health Plans and cross-functional partners to support HEDIS audit and submission timelines and requirements.

Requirements

Bachelor's Degree healthcare or a related field or equivalent experience required
2+ years of HEDIS, regulatory, audit, or quality improvement experience, preferably in a healthcare environment required
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future.

Responsibilities

Provide support for HEDIS quality oversight, audit readiness, and submission support activities.
Contribute to process improvement efforts through documentation of lessons learned and enhancement opportunities.
Perform NCQA HEDIS audit activities, including preparation and maintenance of Roadmaps, Section 5 documentation, 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 actively participate in audit meetings, working sessions, and internal stakeholder reviews.
Perform quality checks to ensure audit materials are complete, accurate, and defensible.
Performs other duties as assigned.
Complies with all policies and standards.