Clinical Care Quality Navigator- Full Time

Lake Charles Memorial Hospital; Lake Charles (LA); On-site; USD 50,000 - 70,000; Full time

Job summary

Lake Charles Memorial Hospital is seeking a Clinical Care Quality Navigator to ensure high-quality, patient-centered care within the ambulatory clinic environment. The role emphasizes outreach for annual wellness visits, patient navigation, and closing care gaps to improve patient outcomes and overall quality of care.

You will collaborate with the MMG Quality and Care Management team, coordinate care plans, and support clinicians in meeting preventive service guidelines and performance measures.

Responsibilities

• Annual Wellness Visit Outreach: Conduct proactive outreach to eligible patients to schedule and promote annual wellness visits in accordance with preventive care guidelines.
• Patient Navigation: Serve as a primary point of contact for patients, assisting them in navigating the healthcare system and accessing necessary services and resources.
• Gap Closure for HEDIS and other contracted quality measures: Identify care gaps through analysis of patient data, EHRs, and quality performance metrics; collaborate to implement targeted interventions; maintains payor rosters.
• Care Coordination: Facilitate communication among providers and services to ensure seamless care coordination and continuity of care for patients.

Job description

DESCRIPTION OF POSITION:

• The Clinical Care Quality Navigator plays a crucial role in ensuring the delivery of high-quality, patient centered care within the ambulatory physician clinic setting. This position requires a skilled healthcare professional with a strong background in clinical care, patient navigation, and quality improvement. The Clinical Care Quality Navigator is responsible for conducting outreach for annual wellness visits, navigating patients through the healthcare system, and closing care gaps to optimize patient outcomes and enhance overall quality of care.

SUPERVISION: Reports directly to the Director of MMG Quality and Care Management

RESPONSIBILITIES AND DUTIES:

Annual Wellness Visit Outreach:

• Conduct proactive outreach to eligible patients to schedule and promote annual wellness visits in accordance with preventive care guidelines.
• Educate patients about the importance of annual wellness visits, preventive screenings, and health maintenance activities to support proactive healthcare management.

Patient Navigation:

• Serve as a primary point of contact for patients, assisting them in navigating the healthcare system and accessing necessary services and resources.
• Provide guidance and support to patients in scheduling appointments, obtaining referrals, coordinating care transitions, and addressing healthcare-related concerns.

Gap Closure for HEDIS and other contracted quality measures:

• Identify care gaps through analysis of patient data, electronic health records (EH Rs), and quality performance metrics.
• Collaborate with healthcare providers and care teams to develop and implement targeted interventions to close care gaps and improve adherence to recommended preventive care and treatment guidelines.
• Maintains and manages payor rosters.

Care Coordination:

• Facilitate communication and collaboration among healthcare providers, specialists, and ancillary services to ensure seamless care coordination and continuity of care for patients.
• Assist in the development and implementation of care plans tailored to individual patient needs and preferences.

Patient