Quality Care Member Advocate
Core
Serves as a vital link between members and the healthcare system, focusing on improving health outcomes by identifying and closing care gaps through community engagement and member education.
Role type
Senior IC community health advocate (hybrid field/remote)
Builds
Member care plans, care gap closures, and community resource connections
Domain
Healthcare / Public Health / Social Services
Deliverable
physical/clinical work
Required skills
Community outreach, home visit assessments, care coordination, navigating healthcare/social service systems, chronic condition management education, data documentation, regulatory compliance
Preferred skills
Clinical Social Work (LCSW), Registered Nurse (RN)
Technologies
HEDIS, CAHPS, member management systems
Responsibilities
Conduct outreach to identify care gaps and connect members with healthcare services; Perform home visits to evaluate needs and identify social determinants of health; Assist members in navigating complex systems and accessing benefits; Collaborate with providers to share quality performance data; Educate members on preventive care and chronic condition management; Document interactions and referrals in appropriate systems; Partner with internal departments to align efforts and improve outcomes; Monitor and report on outreach effectiveness and care gap closure metrics.
Seniority
Mid-level, hands-on IC