RN Quality Navigator for Medicare Stars & Care Gaps

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

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