Preventative Care Advocate

Job Type

Full-time

Description

JOB SUMMARY

The Preventative Care Advocate supports Quality Improvement and Population Health initiatives within a Managed Services Organization (MSO) serving an Independent Practice Association (IPA) network. This role is responsible for promoting compliance with Healthcare Effectiveness Data and Information Set (HEDIS), CMS Star Ratings, NCQA accreditation standards, DMHC regulatory requirements, and contracted health plan quality programs.

The Preventative Care Advocate works directly with contracted provider offices to improve preventive care delivery, close care gaps, and enhance clinical documentation and quality performance. This position serves as a liaison between the MSO, IPA providers, and health plan partners to facilitate quality improvement initiatives, support audit readiness, and improve overall patient outcomes and performance metrics.

Requirements

MINIMUM & PREFERRED QUALIFICATIONS

Education/Training

Minimum: High school diploma or equivalent required

Preferred: Associate's degree or higher in healthcare administration, public health, social services, or related field. Certification as a Medical Assistant.

Experience

Minimum: At least two years of experience in healthcare operations, quality improvement, medical office operations, care coordination, or managed care environment.

Preferred: Experience supporting HEDIS, CMS Star Ratings, or NCQA quality programs. Experience working in an MSO, IPA, or managed care organization. Experience supporting Medicare Advantage, Medi-Cal, or commercial populations. Experience with medical record abstraction and quality reporting processes.

Certification(s)

Certified Professional in Healthcare Quality (CPHQ), Medical Assistant certification, or related healthcare certification preferred.

Skills, Knowledge & Abilities

• Knowledge of HEDIS measures and preventive care quality standards preferred.
• Understanding of NCQA, CMS, DMHC, and health plan quality program requirements preferred.
• Knowledge of preventive care guidelines and population health principles.
• Proficiency in Microsoft Office applications, including Excel and PowerPoint.
• Ability to work with electronic health record systems and quality reporting tools.
• Strong organizational and tracking skills.
• Excellent verbal and written communication skills.
• Ability to educate and engage provider offices and interdisciplinary teams.
• Ability to establish and maintain effective working relationships.
• Strong attention to detail and data accuracy.
• Ability to manage multiple priorities and deadlines.
• Ability to work independently and collaboratively.
• Bilingual (Spanish or other threshold language) preferred.
• Knowledge of managed care and IPA environments preferred.