• Provider Quality Consultant (Johnson City, Knoxville, and/or Chattanooga Regions)

    BlueCross BlueShield of TennesseeChattanooga, TN 37404

    Job #1205125873

  • The Provider Quality Consultant will function as a provider-facing expert in the field of quality- based activities and supporting Provider Engagement programs. The incumbent is accountable for effective implementation and evaluation of quality programs and functions as an expert regarding program management, HEDIS and external stakeholder strategies. This position develops and delivers education and consultation to providers' and provider practice sites in regards to varying quality measures, such as the National Committee for Quality Assurance (NCQA) HEDIS measures.Job Description:Job Responsibilities+ Interfaces with provider quality programs, as well as with other cross-functional programs across the Enterprise functioning as consultant on provider quality performance and improvement initiatives.+ Works closely in collaboration with multi-disciplinary member and provider facing teams to execute provider pay for quality programs which align goals to achieve high quality care.+ Conducts frequent face-to-face provider office visits and functions as subject-matter consultant on provider performance quality measures, reporting, and data.+ Drives and directs recommendations for action designed to achieve quality and productivity improvement goals.+ Provides education to internal as well as external stakeholders on best practices in delivering high quality care and functions as a liaison regarding quality support tools provided to stakeholders; looking beyond the purely "medical" issues confronting families.+ Must be able to travel up to 60% of the time.Job Qualifications_Education+ Bachelor's Degree in a Health Related Discipline (Nursing, Dietetics, Exercise Science, Counseling, Social work, Healthcare Administration, Public Health, or Health Education), or equivalent work experience required._Experience+ 3 years -Clinical experience or prior experience in public health,healthcare administration, or community health / outreach required.+ 3 years - Experience directly related HEDIS and/or Quality Improvement, with experience in data analysis and providing consultation and education to providers and provider staff required._Skills\Certifications_+ Demonstrated presentation and team facilitation skills+ Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)+ Excellent oral and written communication skills+ Be organized, reliable, and able to manage multiple tasks with exceptional work ethic.+ Knowledge of Provider quality strategies, programs, and servicesJob Specific Requirements: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. The employee will also be required to adhere to the guidelines set forth through the program. This includes, maintaining a valid driver's license, auto insurance compliance with minimum liability requirements; as defined in the "Use of Non BCBST-Owned Vehicle" Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR).*The definition for "routine basis" is defined as daily, weekly or at regularly schedule times.Number of Openings Available:2Worker Type:EmployeeWorker Sub-Type:RegularCompany:VSHP Volunteer State Health Plan, IncApplying for this job indicates your acknowledgement and understanding of the following statement:BCBST is an Equal Opportunity employer (EEO), and all employees and applicants will be entitled to equal employment opportunities when employment decisions are made. BCBST will take affirmative action to recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:BCBST's EEO Policies/NoticesBlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.Tobacco-Free Hiring StatementTo further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products (including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, gum, patch, lozenges and electronic or smokeless cigarettes) in any form in Tennessee and where state law permits. A tobacco or nicotine free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a background check which includes an illegal drug and tobacco/nicotine test. An individual whose post offer screening result is positive for illegal drugs or tobacco/nicotineand/or whose background check is verified to be unsatisfactory, will be disqualified from employment, the job offer will be withdrawn, and they may be disqualified from applying for employment for six (6) months from the date of the post offer screening results.Resources to help individuals discontinue the use of tobacco/nicotine products include ~~~ or 1-800-QUIT-NOW.About UsAs Tennessee's largest health benefit plan company, we've been helping Tennesseans find their own unique paths to good health for over 65 years. More than that, we're your neighbors and friends - fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow.

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