Apply to Future Opportunities - RN Clinical Liaison/Quality Practice Advisor (Hybrid)

Healthmap Solutions • Miami, FL

6d • Hybrid

About The Position

Healthmap Solutions is seeking an RN Quality Practice Advisor to coordinate performance improvement activities aimed at enhancing the health outcomes of Healthmap Solutions members. This role involves close collaboration with the Care Navigation team to elevate the quality of the Kidney Health Management clinical program. The position requires building partnerships with clinical providers, identifying areas for improvement through data analysis, and educating practices on best practices and HEDIS measures. The advisor will also assist in process improvement initiatives within provider offices and support the identification of members who would benefit from Care Navigation services. Key responsibilities include educating provider offices on chronic kidney disease and related topics, fostering cross-functional relationships, maintaining detailed documentation compliant with NCQA standards, and ensuring timely report delivery.

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
• 3+ years of progressive experience in healthcare services, clinical operations, quality, or care management
• 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

Nice To Haves

• 3 years of experience in claims or gap closure campaigns, preferred
• Prior experience building and managing relationships with health care providers preferred
• Bilingual Spanish/English preferred

Responsibilities

• Develop a trusting partnership 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level