RN Clinical Liaison/Quality Practice Advisor (Hybrid) - Miami-Dade County, FL - Bilingual Spanish

Healthmap Solutions•Miami, FL

4d•Hybrid

About The Position

The Registered Nurse Quality Practice Advisor coordinates performance improvement activities to engage, educate, and manage efforts to improve Healthmap Solutions members’ health outcomes. The role partners closely with the Care Navigation team to improve the quality of the Kidney Health Management clinical program. The position is hybrid and supports practices in an assigned geographic market, with regular travel to practices and other healthcare or clinical sites as needed.

Requirements

Bachelor’s degree required; 6 or more years of RN experience, including 3 or more years in a position influencing provider behavior, may be considered in lieu of a degree.
Active, unrestricted RN license required.
At least 3 years of progressive experience in healthcare services, clinical operations, quality, or care management.
Bilingual Spanish and English required.
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.
Proficiency in Microsoft Office, including Outlook, Word, Excel, and PowerPoint.
Valid, unrestricted driver’s license and automobile insurance as required by law.
Same-state residency required.
Must successfully comply with the credentialing process.
Regular travel within the assigned region to practices and other healthcare or clinical sites as needed.

Nice To Haves

Three years of experience in a managed care setting.
Three years of experience in gap-closure campaigns.
Prior experience building and managing relationships with healthcare providers and influencing them.

Responsibilities

Develop trusting partnerships with clinical providers and practice locations.
Use provider-specific data to identify opportunities to improve Healthmap Solutions members’ health outcomes.
Educate providers and share best practices in areas of low provider performance.
Help identify process improvements for provider-office workflows.
Partner with physicians and physician staff to identify members who may benefit from Care Navigation support.
Support operational and clinical stakeholders in identifying, developing, and executing process-improvement initiatives.
Improve provider performance in 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 about chronic kidney disease, end-stage renal disease, renal replacement therapies, and related topics.
Build cross-functional relationships with internal departments, provider partners, and practice staff.
Collaborate with the Care Navigation team to exchange information and enhance care coordination for members.
Document provider meetings and interactions thoroughly to support consistent, coordinated provider engagement.
Maintain documentation in compliance with National Committee for Quality Assurance (NCQA) standards.
Ensure timely and successful delivery of reports to internal and external stakeholders.
Perform other related duties as assigned.