Quality Incentive Consultant- West TN

Posted Yesterday
Be an Early Applicant
2 Locations
In-Office or Remote
Mid level
Healthtech • Insurance
The Role
Partner with contracted providers to resolve data issues, educate on clinical quality programs (HEDIS/Medicare/CMS Stars), update policies, analyze trends, and drive quality improvement. The role requires frequent provider-facing travel, presentations, and use of Excel and analytics to improve provider performance and patient outcomes.
Summary Generated by Built In

We are seeking a dedicated, experienced professional in quality improvement to join the team at BlueCross BlueShield of Tennessee

Join us as a Quality Incentive Consultant and play a key role in shaping programs that directly elevate provider performance, improve quality ratings, and enhance patient satisfaction. In this impactful, relationship‑driven role, you’ll collaborate closely with providers to solve problems, analyze trends, and translate data into meaningful improvements.

If you enjoy using your analytical skills and Excel expertise to tell a story and drive change and you’re energized by clear communication, provider education, and continuous improvement, you’ll thrive here. This is an opportunity to influence real outcomes, support provider success, and grow your career in a mission‑focused environment committed to improving the healthcare experience. 

Our ideal candidate will have:

·        Experience leading quality initiatives from planning through execution

·        Ability to manage multiple priorities with strong attention to detail

·        Comfortable presenting to varied audiences and influencing without authority

·        Quality background and/or HEDIS, Medicare, CMS Stars experience preferred

·        Strong analytical, technical, and digital skills

·        Creative and adaptable; eager to responsibly leverage enterprise‑approved AI and technology to improve care and efficiency

·        Strong familiarity with Excel and other major Microsoft applications

Note:

  • Although we are based in Chattanooga, TN, this is a fully remote role. Candidates living in West Tennessee region are preferred- Jackson TN or Memphis TN.
  • This role is fully remote but may require up to 60% travel to Provider Offices, Depending on the business needs.
  • Sponsorship is not available for this position.

Job 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.

Job Qualifications

Education

  • Bachelors Degree in a Health Related Discipline (Nursing, Dietetics, Exercise Science, Counseling, Social work, or Health Education) or equivalent work experience required.

Experience

  • 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

Skills\Certifications

  • 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
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

1

Worker Type:

Employee

Company:

BCBST BlueCross BlueShield of Tennessee, Inc.

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will 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/Notices

BlueCross 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.

Skills Required

  • Bachelor's degree in a health-related discipline or equivalent work experience
  • 4 years quality improvement experience
  • 2 years experience in the healthcare industry
  • Comprehensive knowledge of Medicare, HEDIS, and CMS Stars (1 year)
  • Proficient in Microsoft Office (Outlook, Word, Excel, PowerPoint)
  • Strong analytical skills and ability to translate data into improvements
  • Excellent oral and written communication and presentation skills
  • Ability to manage multiple priorities, solve problems, and meet critical deadlines
  • Demonstrated consumer healthcare market understanding/knowledge
  • Demonstrated ability to work effectively with senior leadership
  • Travel required approximately 60% of the time
  • Maintain valid driver's license, auto insurance, and acceptable motor vehicle record
  • Various immunizations and/or associated medical tests may be required
  • Experience leading quality initiatives from planning through execution
  • Quality background and/or HEDIS, Medicare, CMS Stars experience
  • Creative and adaptable; willing to responsibly use enterprise-approved AI and technology
  • Candidates located in West Tennessee (Jackson or Memphis) preferred
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The Company
HQ: Chattanooga, TN
4,517 Employees
Year Founded: 1945

What We Do

As Tennessee's largest health plan, we've been helping Tennesseans find their own unique paths to good health for more than 70 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. Our mission is simple: peace of mind through better health. We're an independent, not-for-profit, locally governed health plan company – meaning we live and work alongside our Tennessee business customers and plan members. Our 6,000 employees across the state have built our strong reputation for integrity, excellent service and community leadership. But we are also part of the BlueCross BlueShield Association, a nationwide association of health care plans. Because of this, our plan members have access to the same quality health benefits while traveling or living out of state that they have while in Tennessee. © 2018 BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield Association.

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