RN - Clinical Liaison/Quality Practice Advisor (Hybrid)

Healthmap Solutions is the future of specialty health management, focusing on progressive diseases with 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 our clients and employees, championing better health for those who need it most.

About the role

The Registered Nurse, Quality Practice Advisor coordinates performance improvement activities to engage, educate, and manage activities that improve the health outcomes of Healthmap Solutions members. This role partners closely with the Care Navigation team to enhance the quality of the Kidney Health Management clinical program.

Travel: Heavy travel (50%-75%) to support practices in an assigned geographic market, primarily Buffalo, with additional travel to Rochester, Syracuse, and other major markets in Western/Upstate NY.

Responsibilities

• Develop trusting partnerships with clinical providers and practice locations.
• Identify opportunities to improve health outcomes for Healthmap Solutions members based on provider-specific data.
• Incorporate education and communication on best practice sharing for areas of low provider performance.
• Assist in identifying process improvement opportunities in provider office workflows.
• Partner with physicians and staff to identify members who would benefit from Care Navigation support.
• Support operational and clinical stakeholders in developing and executing process improvement initiatives.
• Improve provider performance in areas such as Healthmap Solutions Interventions, Care Gaps, and Chronic Conditions.
• Educate providers on HEDIS measures and open Care Gaps.
• Support the development and implementation of quality improvement interventions.
• Identify opportunities to educate provider offices on topics related to Chronic Kidney Disease, End Stage Renal Disease, and Renal Replacement Therapies.
• Build strong cross-functional relationships with internal departments, provider partners, and practice staff.
• Collaborate with the Care Navigation team to enhance care coordination for Healthmap Solutions members.
• Maintain thorough documentation of all provider meetings and interactions for consistency and coordination.
• Ensure documentation complies with National Committee for Quality Assurance (NCQA) standards.
• Deliver reports to internal and external stakeholders in a timely manner.
• Perform other related duties as assigned.

Requirements

• Bachelor’s degree required.
• Active, unrestricted RN license required.
• 3 years of experience in a healthcare or managed care setting.
• 3 years of experience in claims or gap closure campaigns (preferred).
• 3+ years of progressive experience in healthcare services, clinical operations, quality, or care management.
• Prior experience building and managing relationships with healthcare providers (preferred).
• Valid and unrestricted driver’s license and automobile insurance as required by law; regular travel within the assigned region is required.
• Same state residency required.
• Compliance with organization policies for health screening and immunizations, including:
  • Current Tuberculosis (TB) test or chest X-ray.
  • Proof of immunizations (e.g., Hepatitis B, MMR, Varicella, COVID-19, Influenza).
  • Participation in annual health and wellness screenings.

Skills

• Excellent verbal, written, and presentation skills.
• Strong interpersonal skills to develop and maintain 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: Outlook, Word, Excel, PowerPoint.

Pay

Compensation range: $95,000–$135,000 (dependent on specific market/region and candidate experience).

Benefits

• Competitive Paid Time Off.
• Medical, Dental, and Vision coverage.
• Short-Term and Long-Term Disability.
• 401K with company match.
• Other voluntary benefits as elected.

Physical Demands

The physical demands described are representative of those required to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions.