Preventative Care Advocate
About The Position
The Preventative Care Advocate supports Quality Improvement and Population Health initiatives within a Managed Services Organization (MSO) serving an Independent Practice Association (IPA) network. This role is responsible for promoting compliance with Healthcare Effectiveness Data and Information Set (HEDIS), CMS Star Ratings, NCQA accreditation standards, DMHC regulatory requirements, and contracted health plan quality programs. The Preventative Care Advocate works directly with contracted provider offices to improve preventive care delivery, close care gaps, and enhance clinical documentation and quality performance. This position serves as a liaison between the MSO, IPA providers, and health plan partners to facilitate quality improvement initiatives, support audit readiness, and improve overall patient outcomes and performance metrics.
Requirements
- High school diploma or equivalent required.
- At least two years of experience in healthcare operations, quality improvement, medical office operations, care coordination, or managed care environment.
- Proficiency in Microsoft Office applications, including Excel and PowerPoint.
- Ability to work with electronic health record systems and quality reporting tools.
- Strong organizational and tracking skills.
- Excellent verbal and written communication skills.
- Ability to educate and engage provider offices and interdisciplinary teams.
- Ability to establish and maintain effective working relationships.
- Strong attention to detail and data accuracy.
- Ability to manage multiple priorities and deadlines.
- Ability to work independently and collaboratively.
- Primarily sedentary work involving prolonged computer use.
- Frequent standing, walking, and travel to provider offices may be required.
- Occasional lifting of up to 10 pounds may be necessary.
- Requires the ability to analyze performance data, maintain attention to detail, and communicate effectively.
Nice To Haves
- Associate’s degree or higher in healthcare administration, public health, social services, or related field.
- Certification as a Medical Assistant.
- Experience supporting HEDIS, CMS Star Ratings, or NCQA quality programs.
- Experience working in an MSO, IPA, or managed care organization.
- Experience supporting Medicare Advantage, Medi-Cal, or commercial populations.
- Experience with medical record abstraction and quality reporting processes.
- Certified Professional in Healthcare Quality (CPHQ), Medical Assistant certification, or related healthcare certification.
- Knowledge of HEDIS measures and preventive care quality standards.
- Understanding of NCQA, CMS, DMHC, and health plan quality program requirements.
- Knowledge of preventive care guidelines and population health principles.
- Bilingual (Spanish or other threshold language).
- Knowledge of managed care and IPA environments.
Responsibilities
- Promote compliance with HEDIS, CMS Star Ratings, NCQA accreditation standards, DMHC regulatory requirements, and contracted health plan quality programs.
- Work directly with contracted provider offices to improve preventive care delivery.
- Close care gaps.
- Enhance clinical documentation and quality performance.
- Serve as a liaison between the MSO, IPA providers, and health plan partners to facilitate quality improvement initiatives.
- Support audit readiness.
- Improve overall patient outcomes and performance metrics.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
