Patient Care Advocate-HEDIS

Job Title: Patient Care Advocate Job Description The Patient Care Advocate is responsible for collaborating with members and providers to enhance healthcare delivery by closing care gaps and removing barriers to care. Through outreach and face-to-face interactions at large IPA and group practices, the role aims to improve the member and provider experience. The advocate supports quality improvement interventions, educates on HEDIS measures and coding, and addresses compliance deficiencies. The position involves telephonic outreach to members needing preventive services and assists with scheduling appointments, arranging transportation, and connecting members to community resources. Responsibilities Act as a liaison and advocate between members, families, physicians, and healthcare facilities. Serve as the face of the organization within the provider community, engaging with providers and office staff. Advise and educate provider practices on HEDIS measures and ICD-10/CPT coding in line with NCQA requirements. Assess provider performance data to identify opportunities for improvement and strategize solutions. Collaborate with Provider Relations to enhance provider performance in Quality, Risk Adjustment, and Operations. Schedule doctor appointments for members to ensure access to preventive care and close care gaps. Conduct face-to-face education with members and families in the provider’s office about care gaps and barriers. Perform telephonic outreach and health coaching to support quality improvement and regulatory requirements. Arrange transportation and follow-up appointments for members as needed. Document all member-related interactions and actions taken. Coordinate with other departments, including customer service, to resolve member issues. Complete special assignments and projects critical to department functions. Comply with all policies and scheduling requirements. Essential Skills Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Social Work, Health Administration, or related field, or equivalent work experience. 2+ years of experience in direct patient care, social work, quality improvement, or health coaching, preferably in a managed care environment. Additional Skills & Qualifications Preferred certifications include Licensed Practical Nurse (LPN), Licensed Master Social Worker, Certified Social Worker, Licensed Social Worker, or Licensed Registered Nurse. Work Environment The position operates Monday through Friday from 8 a.m. to 5 p.m. EST, with no weekends, holidays, or overtime required. Job Type & Location This is a Contract position based out of Newark, DE. Pay and Benefits The pay range for this position is $25.00 - $30.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Sep 22, 2026. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options. San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records. Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.