Heritage New York Medical, PC is seeking a dedicated and detail-oriented Registered Nurse (RN) with a strong background in clinical quality measures, care coordination, and outcomes management. The RN Quality Measures will play a critical role in improving patient care by monitoring, reporting, and optimizing performance on quality metrics such as HEDIS, CMS Star Ratings, NCQA standards, and other payer-driven initiatives.

QUALIFICATIONS:

• Active RN license in [State] required.
• Minimum of 3 years clinical experience in Quality Measures.
• Familiarity with HEDIS, Star Ratings, NCQA, CMS quality initiatives, and other healthcare performance metrics.
• Strong organizational and analytical skills; experience with EMR systems preferred.
• Certified Case Manager (CCM) or related certification a plus.
• Bilingual, preferred (Spanish)

PREFERRED EXPERIENCE:

• Direct care with Quality Measures (HEDIS, STARs).
• Knowledge of risk stratification tools and social determinants of health (SDOH).
• Experience in a value-based care or ACO environment.

• Coordinate and manage care for targeted patient populations across the care continuum to improve clinical outcomes.
• Analyze and report on healthcare quality measures, identifying gaps in care and implementing evidence-based interventions.
• Collaborate with providers, interdisciplinary teams, and health plan partners to close gaps in care (e.g., screenings, chronic disease management).
• Review medical records and use EMR data to track compliance with quality standards.
• Educate patients, families, and providers on preventive health guidelines and care plan adherence.
• Participate in audits, chart reviews, and data validation for reporting to payers and regulatory bodies.
• Lead or support quality improvement projects aligned with HEDIS, CAHPS, CMS, or ACO benchmarks.
• Maintain detailed and accurate documentation in care management and quality tracking systems.