Senior HEDIS Quality – Audit Analyst

Centene Corporation

Senior HEDIS Quality & Audit Analyst at Centene managing quality oversight and audit readiness. Independently leads complex audit workstreams and ensures compliance with regulatory standards.

Posted 6/11/2026full-timeRemote • Texas • 🇺🇸 United StatesSenior💰 $70,100 - $126,200 per yearWebsite

About the role

Key responsibilities & impact

Serve as a senior subject matter expert for HEDIS quality oversight, audit readiness, and submission support activities
Independently lead complex NCQA audit workstreams, including Roadmaps, Section 5 documentation, measure-specific evidence, CAHPS and auditor communications
Interpret and apply federal and state regulatory requirements, and applicable state regulations, to HEDIS documentation, workflows, and data use
Provide expert guidance on reporting population applicability/management, measure selection, and submission requirements
Identify, assess, and mitigate audit and submission risks; lead root cause analysis and development of corrective actions for high-risk or complex issues
Support CMS submission activities, including PLD coordination, testing validation, and final submission readiness
Develop, refine, and maintain enterprise standards, templates, controls, and documentation to ensure audit-defensible outcomes
Act as an escalation point for complex audit findings, regulatory interpretation questions, and submission decisions
Contribute to leadership-level reporting, audit narratives, and governance materials
Drive continuous improvement initiatives to strengthen HEDIS audit readiness and submission accuracy.
Performs other duties as assigned

Requirements

What you’ll need

Bachelor's Degree in Healthcare or related field, or equivalent experience required
Bachelor's Degree preferred in Healthcare or related field
4+ years Related experience in HEDIS, Quality Audits, or regulated healthcare environments required
Project management experience in HEDIS, regulatory, audit, or quality improvement experience preferred
LTSS experience highly preferred

Benefits

Comp & perks

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

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

HEDISNCQA auditregulatory interpretationroot cause analysiscorrective actionssubmission supportquality auditsproject managementdata managementcontinuous improvement

Soft Skills

leadershipcommunicationproblem-solvinganalytical thinkingrisk assessmentcollaborationguidanceescalation managementreportingdocumentation