Quality Practice Advisor (HEDIS)

Location: Remote-TX; candidates must reside in Texas. Hybrid work includes remote duties and local travel to provider offices, with travel of up to 75% of the time. Preference is given to candidates in Northwest or Northeast Harris County, including Cypress, Tomball, Spring, Humble, Atascocita, Kingwood, and surrounding communities.

Pay range: $27.02–$48.55 per hour.

Company

hirify.global connects people with healthcare services and supports more accessible and effective care.

What you will do

• Build and maintain clinical relationships with large physician practices, IPAs, and provider sites across product lines.
• Educate providers on HEDIS measures, medical record documentation, risk adjustment, and ICD-9/10 and CPT coding.
• Collect, summarize, and analyze provider quality and risk adjustment data to identify improvement opportunities and close care gaps.
• Collaborate with Provider Relations and other provider-facing teams to improve Quality, Risk Adjustment, Operations, claims, and encounters.
• Develop and support quality improvement interventions, audits, and practice-specific solutions.
• Maintain Quality KPIs and HEDIS abstraction accuracy in line with corporate standards.

Requirements

• Must reside in Texas and be authorized to work in the U.S. without current or future employment-based visa sponsorship.
• Bachelor's degree or equivalent.
• At least 3 years of experience in HEDIS record collection and risk adjustment coding.
• One of the following certifications or licenses: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A, or CBCS.
• Ability to travel up to 75% of the time to provider offices.

Nice to have

• RHIT certification where applicable to a state-specific health plan.
• License or certification for Superior HealthPlan positions.

Culture & Benefits

• Flexible work approach combining remote, hybrid, field, or office schedules.
• Health insurance, 401(k), and stock purchase plans.
• Tuition reimbursement, paid time off, and holidays.
• Work focused on improving healthcare access and outcomes for individuals, families, and communities.