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[Remote] Quality Incentive Consultant- West TN

Remote · Brazil Full-time

Note: The job is a remote job and is open to candidates in USA. BlueCross BlueShield of Tennessee is seeking a dedicated Quality Incentive Consultant to join their team. The role focuses on enhancing provider performance and quality ratings through collaboration and data analysis, while also requiring strong communication and analytical skills.

Responsibilities

  • Work with contracted providers to resolve data issues related to line of business quality programs
  • Update and educate contracted providers and their staff of changes and updates to the clinical quality programs
  • Serves and educates contracted providers on measures in the line of business quality program, preferred quality reporting, quality measure clinical documentation and BCBST Quality programs policies, procedures, and technologies
  • Work with Supervisor to update policies and procedures as needed to improve operations of the line of business quality program
  • Travel required approximately 60% of the time
  • Various immunizations and/or associated medical tests may be required for this position

Skills

  • Bachelors Degree in a Health Related Discipline (Nursing, Dietetics, Exercise Science, Counseling, Social work, or Health Education) or equivalent work experience required
  • 4 years - Quality improvement experience required
  • 2 years - Experience in the healthcare industry required
  • 1 year - Comprehensive knowledge base crossing all areas within Medicare, HEDIS and CMS Stars program
  • Demonstrated ability to effectively work with senior leadership teams
  • Ability to speak in public and conduct effective presentations
  • Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)
  • Capacity to solve problems and manage multiple assignments with critical deadlines
  • Excellent oral and written communication skills
  • Strong analytical skills
  • Demonstrated consumer healthcare market understanding/knowledge required
  • Quality background and/or HEDIS, Medicare, CMS Stars experience preferred
  • Candidates living in West Tennessee region are preferred- Jackson TN or Memphis TN

Benefits

  • Fully remote role with up to 60% travel to Provider Offices
  • Employees who are required to operate either a BCBST-owned vehicle or a personal or rental vehicle for company business on a routine basis will be automatically enrolled into the BCBST Driver Safety Program, including maintaining a valid driver’s license, auto insurance compliance, and an acceptable motor vehicle record (MVR)

Company Overview

  • As Tennessee's largest health plan, we've been helping Tennesseans find their own unique paths to good health for more than 70 years. It was founded in 1945, and is headquartered in Chattanooga, Tennessee, USA, with a workforce of 5001-10000 employees. Its website is http://www.bcbst.com.
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