Company Background

Healthmap Solutions (Healthmap) is an NCQA-accredited industry leading kidney population health management company. Healthmap uses big data resources, integrated advanced technology, clinical expertise, and complex care management to improve the lives of people living with kidney disease. Healthmap also helps healthcare providers and payers achieve the value-based results they need. Our company is a diverse and growing organization committed to our clients, the patients we support, and our employees.

We are champions for better health, for those who need us most.

Position Summary

The Clinical Practice Advisor will work under the direction of the Director of Clinical Services and be responsible for the design and management of clinical and quality activities related to onboarded providers within a defined geographic area. In partnership with the Provider Relationship Manager, enhances and maintains the provider relationship with clinical and quality interventions and is jointly accountable for meeting the operational and quality objectives of the program.

The Clinical Practice Advisor is responsible for the oversight of daily assignments, workflows and ensures consistency in interventions supporting our clients. This position will closely partner with Provider Relations and Care Management teams to improve the quality of the Kidney Health Management clinical program.

Responsibilities

• Collaborates with onboarded providers to identify patients that would benefit from program interventions and refers eligible patients to care navigation.
• Partners with physicians/physician staff to find ways to encourage member clinical participation in wellness and education.
• Shares insights and analytic reporting results to practices for patient behavior modification opportunities to result in improved quality of life and cost savings.
• Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and strategize/coach on opportunities for provider improvement and care gap closure
• Collaborates with Provider Relations Manager to improve provider performance in areas of Quality, Risk Adjustment, and Operations.
• Educates providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment.
• Supports the development and implementation of quality improvement interventions.
• Provides communication such as white papers, member education, outreach interventions, and provider education.
• Identify and resolve operational challenges using defined processes, expertise, and judgment relevant to the client, patient, and team needs
• Handles client outreach and successful communication to and from providers, balancing excellent customer service with efficiency
• Provides accurate monitoring of patient/physician compliance with guidelines and recommendations, providing deliverables, conducting outreach, and maintaining provider profiles
• Builds strong cross-functional relationships with internal departments and provider partners and practice staff
• Maintains and documents all applicable practice/patient updates and follow up communications
• Ensures timely and successful delivery of reports to internal and external stakeholders.
• Performs proficiently in all competency areas including but not limited to customer and client needs, patient dynamics, and analytically driven data reporting
• Performs other related duties as assigned

Requirements

• Bachelor's Degree preferred – in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field
• RN/LPN with valid licensure required
• 3+ years of progressive experience in healthcare services clinical operations directly leading to revenue growth from targeted population health, CKD & ESRD preferred
• 3 years of experience in claims or gap closure campaigns
• 3 years of experience in the clinical setting or managed care setting and patient-driven customer service and interaction is required
• Per Healthmap’s HR Security Policy, this position is considered HY (high risk for PHI and may require additional training/screening)
• Work from home within commutable range of region, city, or state
• Proof of valid and unrestricted driver’s license required
• Same state residency required
• Proof of full Covid-19 vaccination

What You Bring to the Team

• Excellent presentation skills, interpersonal skills as well as excellent written and verbal communication skills to the target audience.
• Strong relationship-building skills, multitasking, prioritization, and solutions-oriented.
• Strong strategic thinking, critical thinking, analytical ability, verbal and written communication skills to the target audience.
• Metrics-driven ability to understand key goals from the program and understand reporting results to communicate areas of opportunity to physicians and/or office staff for behavior modifications.
• Must be proficient in Microsoft Office: Outlook, Word, Excel, PowerPoint

Why Join Healthmap Solutions?

Be a Champion for Better Health: Healthmap Solutions is transforming the kidney population health management industry and improving the healthcare experience for patients. Healthmap has a proven formula for driving success for its clients and patients.

Unmatched Expertise in Mapping a Healthier Future: Healthmap Solutions uses proprietary algorithms, big data, and personalized interactions to drive better health outcomes for patients and value-based care for health plans.

Exciting Opportunities: Healthmap is poised for hyper growth and needs talent with vision to see the future state and willingness to jump in and build it.

Meaningful Partnerships: Healthmap Solutions has been recognized as a top employer by numerous media and professional organizations. Talented, passionate individuals make the difference in this fast-moving, collaborative, diverse, and inspiring environment.

Growth and Innovation: At Healthmap, we are just getting started. Come grow with us and support our mission to make a tangible difference in the lives of our members.

The road to better kidney health management starts with Healthmap Solutions.

As an Equal Opportunity Employer, we will not discriminate against any job candidate or employee due to age, race, religion, ethnicity, national origin, gender, gender identity/expression, sexual orientation, disability, familial status, veteran status, marital status, parental status, or pregnancy. In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind.