Familiarity with HEDIS, QARR, and Stars specifications
Strong analytical and communication skills
Responsibilities
Support quality improvement initiatives for better clinical outcomes
Ensure compliance with preventive care guidelines
Use HEDIS and QARR knowledge for effective interventions
Identify patients with care gaps using analytics and registries
Execute outreach to promote preventive and chronic care
Document clinical support for care gap closures in Epic
Monitor outreach outcomes to guide quality improvements
Enhance patient satisfaction through effective communication
Support transitions of care to reduce readmissions
Partner with clinical teams for coordinated care
Benefits
Embedded role within provider practices
Opportunity to impact Medicare Stars and value-based care
Collaborative work with interdisciplinary teams
Access to data analytics for improving outcomes
Engagement with community resources for patient support
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
