Quality Practice Advisor

Responsibilities

• Develop trusting partnerships with clinical providers and practice locations to improve health outcomes.
• Identify opportunities for performance improvement based on provider-specific data and HEDIS measures.
• Educate providers on best practices, chronic kidney disease, and renal replacement therapies.
• Partner with the Care Navigation team to enhance care coordination and identify members needing support.
• Support the development and execution of clinical process improvement initiatives and workflows.
• Maintain thorough documentation of provider interactions in compliance with NCQA standards.
• Deliver timely reports to internal and external stakeholders.

Requirements

• Bachelor’s degree.
• Active, unrestricted RN license.
• Basic Life Support (BLS) certification (required within 30 days of hire).
• 3 years of experience in a healthcare or managed care setting.
• 3+ years of progressive experience in clinical operations, quality, or care management.
• Valid driver’s license and automobile insurance.
• Must reside in the same state as the assigned territory.
• Ability to travel heavily (over 50%) to support practices within the assigned region.

Preferred Qualifications

• 3 years of experience in claims or gap closure campaigns.
• Prior experience building and managing relationships with healthcare providers.

About the Company

Healthmap Solutions is the future of specialty health management, focusing on progressive diseases with particular expertise in kidney health populations. We use clinical big data and high-powered analytics to power complex specialty health management programs. We are a diverse, growing company committed to being champions for better health for those who need us most.