Rn Jobs in Port St Lucie

About The Position

Requirements

• Bachelor’s degree required; six or more years of RN experience, including three or more years in a position that influences provider behavior, may be considered in lieu of the degree.
• Active, unrestricted RN license required.
• Three or more years of progressive experience in healthcare services, clinical operations, quality, or care management.
• Valid and unrestricted driver’s license and automobile insurance as required by law; the position requires regular travel within the assigned region.
• Residency in the same state 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.

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.
• Share best practices and provide education and communication in areas of low provider performance.
• Assist in identifying provider-office workflow process improvements.
• 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 related to Healthmap Solutions interventions, care gaps, and chronic conditions.
• Educate providers about 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 strong cross-functional relationships with internal departments, provider partners, and practice staff.
• Collaborate with the Care Navigation team to exchange information and enhance member care coordination.
• Maintain thorough documentation of provider meetings and interactions to support 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.