Associate Quality Practice Advisor (HEDIS)

Location: Remote role limited to Southeast Pennsylvania; requires travel up to 75% of the time

Salary: $27.02–$48.55 per hour

Company

hirify.global connects people with healthcare services and supports healthier communities through managed care and quality-focused programs.

What you will do

• Educate community physicians and small provider practices on NCQA HEDIS measures, medical record documentation, and ICD-9/10 and CPT coding.
• Collect, summarize, and trend provider performance data to identify improvement opportunities.
• Deliver provider-specific metrics and coach practices on closing care gaps and improving quality, risk adjustment, and operations.
• Partner with physicians, provider staff, and Provider Relations to address practice needs and support member wellness and education.
• Document visits, findings, action plans, outcomes, quality-of-care concerns, and data in designated systems.
• Support HEDIS studies and regulatory reporting by requesting records, maintaining databases, researching encounter history, and validating submissions.

Requirements

• Must be authorized to work in the United States without current or future employment-based visa sponsorship.
• Must live in Southeast Pennsylvania, have reliable transportation, and hold a valid driver's license.
• Bachelor's degree in healthcare, public health, nursing, psychology, health administration, social work, or a related field, or equivalent managed-care experience.
• At least 1 year of HEDIS medical record review or quality improvement experience with data and chart reviews, or 2 years of medical coding or transferable experience.
• Ability to educate providers, analyze medical records and performance data, and work with HEDIS documentation and coding requirements.

Nice to have

• Master's degree in healthcare, public health, nursing, psychology, health administration, social work, or a related field.
• Professional certification or license such as CCS, LPN, LMSW, LVN, LMHC, LMFT, LCSW, RN, APRN, HCQM, CHP, or CPHQ.

Culture & Benefits

• Meaningful healthcare work supporting individuals, families, and communities.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Flexible work approaches may include remote, hybrid, field, or office schedules, subject to role requirements.
• Equal opportunity employment and consideration under applicable fair-chance laws.