Healthmap Solutions is hiring a Healthmap Solutions Careers - RN Quality Practice Advisor

Healthmap Solutions is looking for an RN Quality Practice Advisor to coordinate performance improvement activities that engage, educate, and manage care to improve health outcomes for our members. In this role, you will closely partner with our Care Navigation team to enhance the quality of our Kidney Health Management clinical program.

What You'll Do

• Develop a trusting partnership with clinical providers and practice locations.
• Identify opportunities to improve health outcomes for members based on provider-specific data.
• Incorporate education and communication on Best Practice sharing for identified areas of provider low performance.
• Provide assistance in identifying areas for process improvement in provider office workflows.
• Partner with physicians and physician staff to identify members that would benefit from Care Navigation support.
• Support operational and clinical stakeholders in the identification, development, and execution of process improvement initiatives.
• Improve provider performance in areas such as Healthmap Solutions Interventions, Care Gaps, and Chronic Conditions.
• Educate providers on HEDIS measures and open Care Gaps.
• Support the development and implementation of quality improvement interventions.
• Identify opportunities to educate provider offices on topics related to Chronic Kidney Disease, End Stage Renal Disease, and Renal Replacement Therapies.
• Build strong cross-functional relationships with internal departments and provider partners and practice staff.
• Collaborate with the Care Navigation team to provide and receive information to enhance care coordination for members.
• Maintain thorough documentation of all provider meetings and interactions for consistency and coordination.
• Maintain documentation in compliance with National Committee for Quality Assurance (NCQA) standards.
• Ensure timely and successful delivery of reports to internal and external stakeholders.

What We're Looking For

• Bachelor’s degree in Nursing required.
• Active, unrestricted RN license required.
• Basic Life Support (BLS) certification required.
• Advanced Cardiovascular Life Support (ACLS) certification (based on role).
• 3+ years of experience in a health care or managed care setting.
• 3+ years of progressive experience in healthcare services, clinical operations, quality, or care management.
• Proof of valid and unrestricted driver’s license and automobile insurance as required by law.
• Same state residency required.
• Must comply with organization policies for health screening and immunizations, including but not limited to: current Tuberculosis (TB) test or chest X-ray, proof of immunizations (Hepatitis B, MMR, Varicella, COVID-19, Influenza), and participation in annual health and wellness screenings.
• Excellent verbal, written, and presentation skills.
• Interpersonal skills to develop and maintain strong internal and external relationships.
• Ability to multitask, prioritize, and create solutions in a fast-paced environment.
• Strong critical thinking and analytical skills.
• Must be proficient in Microsoft Office: Outlook, Word, Excel, PowerPoint.

Nice to Have

• 3+ years of experience in claims or gap closure campaigns.
• Prior experience building and managing relationships with health care providers.

Technical Stack

• Microsoft Office: Outlook, Word, Excel, PowerPoint

Team & Environment

This role partners closely with the Care Navigation team.

Work Mode

This position offers a hybrid work model.

As an Equal Opportunity Employer, we will not discriminate against any job candidate or employee due to age, race, religion, ethnicity, national origin, gender, gender identity/expression, sexual orientation, disability, familial status, veteran status, marital status, parental status, or pregnancy. In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind.