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 home visits.
Role type
Field-based member advocate and care coordinator
Builds
Member health outcomes and care continuity
Domain
Healthcare / Public Health
Deliverable
physical/clinical work
Required skills
Care coordination, community outreach, home visit assessments, social determinants of health analysis, care plan navigation, benefits entitlement access, data documentation, regulatory compliance
Preferred skills
Chronic disease management, preventive care outreach, HEDIS/CAHPS quality measures, Medicaid/Medicare program knowledge, bilingual English/Spanish
Technologies
HEDIS, CAHPS
Responsibilities
Conduct community 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 healthcare and social service systems; collaborate with providers to share quality performance data; educate members on preventive care and chronic condition management; document interactions and referrals in appropriate systems; monitor and report on outreach effectiveness and care gap closure metrics.
Seniority
Individual Contributor, mid-level (3+ years preferred)
