Familiarity with HEDIS, QARR, or quality improvement programs
Strong analytical and communication skills
Responsibilities
Support quality improvement initiatives to enhance clinical outcomes
Ensure adherence to preventive care and clinical guidelines
Identify and prioritize patients with care gaps using analytics
Execute proactive outreach for preventive and chronic care adherence
Track and analyze outreach outcomes for quality improvement
Reinforce best practices in patient communication and follow-up
Identify high-risk patients and support care coordination
Benefits
Health insurance and retirement plans
Professional development opportunities
Collaborative team environment
Access to clinical resources and analytics tools
Opportunity to impact patient care and quality outcomes
Full Job Description
Summary of Position
The Quality Navigator serves as an embedded clinical quality resource within assigned provider practices to improve Medicare Stars, HEDIS, QARR, and value-based care performance outcomes. The role partners directly with providers, office leadership, care management teams, and interdisciplinary stakeholders to identify and close care gaps, optimize chronic disease management, improve patient engagement, support care transitions, and drive practice-level quality improvement initiatives. The Quality Navigator utilizes clinical expertise, analytics, and performance data to improve member outcomes, enhance patient experience, and achieve organizational quality goals
