Quality Navigator (Registered Nurse) - Jamaica Estates & Valley Stream

AdvantageCare Physicians; New York (NY); On-site; USD 81,000 - 97,000; Full time

Job summary

AdvantageCare Physicians in New York seeks a Quality Navigator to serve as an embedded clinical quality resource within practices, improving Medicare Stars, HEDIS, QARR, and value-based care performance. You will partner with providers and care teams, identify care gaps, drive outreach, and document improvements in Epic, supporting transitions of care and CAHPS outcomes.

The role requires a BSN, NY RN licensure, 2+ years clinical experience, ambulatory exposure, and knowledge of chronic disease

Qualifications

• BSN required.
• Current Licensure as an RN in NYS.

Responsibilities

• Support quality improvement initiatives to enhance clinical outcomes and care delivery.
• Ensure adherence to preventive care and clinical guidelines across assigned measures.
• Identify and prioritize patients with care gaps using analytics, registries, and HEDIS checklists.
• Execute proactive telephonic and digital outreach to drive preventive and chronic care adherence.
• Provide clinical support for care gap closure (e.g., hospital follow-up) and document in Epic.
• Track and analyze outreach outcomes to inform quality improvement efforts.
• Reinforce best practices in communication, education, and follow-up.
• Ensure timely follow-up to improve continuity of care and patient satisfaction.
• Identify and address drivers of CAHPS performance at the practice level.
• Identify high-risk/high-utilizing patients and support care coordination to reduce avoidable ED/IP use.

Skills

Analytical skills

Communication skills

Patient engagement

Education

BSN

RN licensure (NY)

Tools

EMR systems

Population health platforms

Job description

Careers at AdvantageCare Physicians: At AdvantageCare Physicians, our providers and care teams reflect our commitment to population health. Improving the health of our patients is our goal; keeping our patients healthy is our commitment. Using our state-of-the-art electronic medical record (EMR) system, our providers, care teams, and practice administration staff work together to deliver high-quality, comprehensive and convenient care to our patients.

To protect the health and safety of our workforce, members, patients, and the communities we serve, AdvantageCare Physicians require all new employees to be fully vaccinated for COVID-19. Exemption/reasonable accommodations may be granted because of 1) a qualifying medical condition or disability that makes getting the vaccine unsafe for the individual, or 2) objection on the basis of sincerely held religious beliefs and/or practices.

AdvantageCare Physicians (ACPNY) is a primary and specialty care practice serving half a million patients across the New York metropolitan area. With more than 30 medical offices across New York City's five boroughs and Long Island, ACPNY is continually expanding our practice and enhancing our services for communities throughout New York. As we grow, our employees grow with us.

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

Principal Accountabilities

Quality Improvement & HEDIS/QARR/Stars Performance

• Support quality improvement initiatives to enhance clinical outcomes and care delivery.
• Ensure adherence to preventive care and clinical guidelines across assigned measures.

Apply knowledge of HEDIS, QARR, and Stars specifications to guide interventions.

Data-Driven Outreach & Care Gap Closure

• Identify and prioritize patients with care gaps using analytics, registries, and HEDIS checklists.
• Execute proactive telephonic and digital outreach to drive preventive and chronic care adherence.
• Provide clinical support for care gap closure (e.g., hospital follow-up) and document in Epic.

Track and analyze outreach outcomes to inform quality improvement efforts.

Patient Experience & CAHPS Performance

• Reinforce best practices in communication, education, and follow-up.
• Ensure timely follow-up to improve continuity of care and patient satisfaction.

Identify and address drivers of CAHPS performance at the practice level.

Cost of Care & Utilization Management

• Identify high-risk/high-utilizing patients and support care coordination to reduce avoidable ED/IP use.

Support transitions of care and post-discharge outreach to reduce readmissions

Care Team Collaboration & Community Health

• Partner with providers and interdisciplinary teams to support care delivery.

Connect patients to community resources to improve access and outcomes

Qualifications

Education, Training, Licenses, Certifications

• BSN required
• Current Licensure as an RN in NYS

Relevant Work Experience, Knowledge, Skills, and Abilities

• Minimum of 2 years of clinical experience
• Minimum of one year in an ambulatory setting
• Experience in Medicare Advantage, Managed Care, Population Health, Quality Improvement, Care Management, or Value-Based Care
• Experience supporting HEDIS, QARR, Stars, NCQA, or quality improvement programs.
• Knowledge of chronic disease management and care coordination principles.
• Experience working with EMR systems and population health platforms.
• Strong analytical, communication, and patient engagement skills.

Additional Information

• Requisition ID: 1000003259
• Hiring Range: $81,000-$96,900

Pay Disclosure

At AdvantageCare Physicians, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at AdvantageCare Physicians, where your contributions are valued and supported by fair compensation.

EEOC Statement

We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.