Quality Navigator (Registered Nurse)

About the role

The Quality Navigator serves as a clinical quality resource within provider practices to enhance Medicare Stars, HEDIS, QARR, and value-based care outcomes.

Responsibilities

• Support quality improvement initiatives and ensure adherence to clinical guidelines.
• Use analytics to identify and prioritize care gaps, execute outreach, and support care gap closure.
• Improve patient experience through effective communication and timely follow-up.
• Support cost management by identifying high-risk patients and reducing avoidable utilization.
• Collaborate with care teams and connect patients to community resources.

Requirements

• BSN and NYS RN licensure required.
• At least 2 years of clinical experience, including one in ambulatory care.
• Experience with Medicare Advantage, population health, quality programs, and EMR systems.
• Strong analytical, communication, and patient engagement skills.