About The Position

Healthmap Solutions is seeking a Quality Practice Advisor to coordinate performance improvement activities aimed at enhancing the health outcomes of its members, with a special focus on kidney health populations. This role involves close collaboration with the Care Navigation team to elevate the quality of the Kidney Health Management clinical program. The company is a diverse, growing organization dedicated to its clients and employees, championing better health for those in need.

Requirements

  • Bachelor’s degree
  • Active, unrestricted, RN license required
  • Basic Life Support (BLS) certification required for all field roles (within 30 days of hire)
  • 3 years of experience in a health care or managed care setting
  • Prior experience building and managing relationships with health care providers preferred
  • Proof of valid and unrestricted driver’s license required and automobile insurance as required by law; this position requires regular travel within assigned region to support practices and or other healthcare/clinical sites as needed
  • Same state residency required
  • Must comply with organization policies for health screening and immunizations, including but not limited to: Current Tuberculosis (TB) test or current chest X-ray, Proof of immunizations (e.g., Hepatitis B, MMR, Varicella, COVID-19, Influenza), 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, prioritization, 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 Haves

  • 3 years of experience in claims or gap closure campaigns, preferred
  • 3+ years of progressive experience in healthcare services, clinical operations, quality, or care management
  • Bilingual Spanish/English preferred

Responsibilities

  • Develop trusting partnerships with clinical providers and practice locations.
  • Identify opportunities to improve health outcomes for Healthmap Solutions 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/physician staff to identify Healthmap Solutions 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, Renal Replacement Therapies, etc.
  • 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 on Healthmap Solutions members.
  • Maintain thorough documentation of all provider meetings and interactions for consistency and coordination of 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.

Benefits

  • 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.
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