HEDIS- Quality Practice Advisor

Full Time
Entry Level

DRCC is currently seeking a HEDIS Quality Practice Advisor that will Collaborates with Provider Relations and other provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters).

  • 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.


Bachelor’s degree or equivalent required. 3+ years of experience in HEDIS record collection and risk adjustment (coding)


One of the following required: CHRR, CMRR, CCS, CRC, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN.


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