RN Quality Navigator for Medicare Stars & Care Coordination

AdvantageCare Physicians; New York (NY); On-site; USD 81,000 - 96,900; Full time

Job summary

AdvantageCare Physicians (ACPNY) is a leading NY-based primary and specialty care network delivering patient-centered care across multiple offices. The Quality Navigator serves as an embedded clinical quality resource to improve Medicare Stars, HEDIS, QARR, and value-based outcomes by collaborating with providers, care teams, and leadership.

The role focuses on identifying care gaps, conducting data-driven outreach, supporting transitions of care, and advancing CAHPS performance while leveraging

Qualifications

• BSN required; NY RN licensure is required.
• Minimum of 2 years of clinical experience; ambulatory setting experience preferred.
• Experience with Medicare Advantage, Managed Care, Population Health, Quality Improvement, Care Management, or Value-Based Care.
• Knowledge of chronic disease management and care coordination principles.

Responsibilities

• Support quality improvement initiatives to enhance clinical outcomes and care delivery.
• Identify and close 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.

Skills

RN licensure NY

Data analysis

Patient engagement

EMR systems

Education

BSN

Tools

Epic EMR

Job description

AdvantageCare Physicians (ACPNY) is a leading NY-based primary and specialty care network delivering patient-centered care across multiple offices. The Quality Navigator serves as an embedded clinical quality resource to improve Medicare Stars, HEDIS, QARR, and value-based outcomes by collaborating with providers, care teams, and leadership.

The role focuses on identifying care gaps, conducting data-driven outreach, supporting transitions of care, and advancing CAHPS performance while leveraging