Clinical Quality Navigator

Gellert Health; Phoenix (AZ); On-site; USD 85,000 - 110,000; Full time

Job summary

Gellert Health is seeking a Quality Clinician to provide clinical quality oversight, review charts for evidence-based navigation, and identify HEDIS gaps to improve patient outcomes. This role partners with providers and multidisciplinary teams to close care gaps and ensure high-quality care.

You will facilitate patient case conferences, coordinate with hospitals and community partners, and apply evidence-based standards in daily practice to promote continuity and quality of care across settings.

Qualifications

• Active, unrestricted clinical license (e.g., RN, LPN/LVN, NP, PA) in good standing.
• Experience with chart review and quality audits.
• Working knowledge of HEDIS measures and quality standards.
• Experience facilitating multidisciplinary case conferences and care reviews.
• Ability to communicate clinical information across teams and providers.

Responsibilities

• Conduct navigation quality audits and chart reviews requiring clinical training.
• Identify HEDIS care gaps and support closure and quality improvement.
• Review documentation against standards to find missed screenings and preventive care.
• Monitor clinical outcomes and trends to identify concerns.
• Collaborate with hospitals, clinics, social services, payers, and providers to improve care.
• Document case conferences, recommendations, follow-up needs, and quality activities.
• Maintain knowledge of updated clinical guidelines and quality measures.

Skills

Clinical assessment

Critical thinking

EHR familiarity

Written & verbal communication

Care coordination

Independent work

Education

Active, unrestricted clinical license

Job description

Gellert Health is seeking a Quality Clinician to provide clinical quality oversight, review charts for evidence-based navigation, and identify HEDIS gaps to improve patient outcomes. This role partners with providers and multidisciplinary teams to close care gaps and ensure high-quality care.

You will facilitate patient case conferences, coordinate with hospitals and community partners, and apply evidence-based standards in daily practice to promote continuity and quality of care across settings.