Healthmap Solutions is hiring a Hybrid RN Quality Practice Advisor to coordinate performance improvement activities that enhance health outcomes for our members. This role focuses on engaging and educating clinical providers to improve 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 based on provider-specific data
- Educate and communicate on Best Practice sharing for areas of provider low performance
- Assist in identifying areas for process improvement in provider office workflows
- Partner with physicians and staff to identify members who would benefit from Care Navigation support
- Support stakeholders in the identification, development, and execution of process improvement initiatives
- Improve provider performance in areas such as 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 and Renal Replacement Therapies
- Build strong cross-functional relationships with internal departments and provider partners
- Collaborate with the Care Navigation team to enhance care coordination
- Maintain thorough documentation of all provider meetings and interactions
- Ensure documentation compliance with NCQA standards
- Ensure timely delivery of reports to internal and external stakeholders
- Perform other related duties as assigned
What We're Looking For
- Bachelor’s degree
- Active, unrestricted RN license
- Basic Life Support (BLS) certification for field roles (within 30 days of hire)
- 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, unrestricted driver’s license and automobile insurance; regular travel within assigned region required
- Same state residency
- Must comply with all organization policies for health screening and immunizations
Nice to Have
- 3 years of experience in claims or gap closure campaigns
- Prior experience building and managing relationships with health care providers
Work Mode
This position operates on a hybrid schedule.
