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 position partners closely with the Care Navigation team to improve the quality of the Kidney Health Management clinical program. It requires regular travel within the assigned region to support practices and other healthcare or clinical sites as needed; travel is heavy and exceeds 50%. Same-state residency is required, and the employee must successfully complete the credentialing process.

Requirements

  • Bachelor’s degree required; six or more years of RN experience, including three or more years in a position influencing provider behavior, may be considered in lieu of a degree.
  • Active, unrestricted RN license required.
  • Three or more years of progressive experience in healthcare services, clinical operations, quality, or care management.
  • Valid, unrestricted driver’s license and automobile insurance as required by law.
  • Same-state residency required.
  • Must successfully comply with the credentialing process.
  • 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.
  • Ability to travel regularly within the assigned region; travel is over 50%.

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 provider behavior.

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 and communicate best practices in areas of identified low provider performance.
  • Assist in identifying opportunities to improve provider-office workflows.
  • Partner with physicians and their staff to identify members who could benefit from Care Navigation support.
  • Support operational and clinical stakeholders in identifying, developing, and executing process-improvement initiatives.
  • Improve provider performance in areas including 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 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 Healthmap Solutions members.
  • Maintain thorough documentation of provider meetings and interactions 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.
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