Note: The job is a remote job and is open to candidates in USA. BlueCross BlueShield of Tennessee is seeking a dedicated, experienced, and forward-thinking Quality Incentive Consultant. In this role, the Consultant serves as a strategic driver of quality and cost improvement, translating TennCare’s priorities into actionable initiatives that enhance quality performance and overall care delivery for members.
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
Company Overview