[Hiring] Provider Quality Consultant @BlueCross BlueShield of Tennessee

Role Description

Our BlueCare team has an exciting opportunity for a Provider Quality Consultant to support TennCare's innovative Health Starts initiative. In this role, you will serve as the primary liaison between participating provider groups, driving collaboration across providers, MCO partners, and TennCare stakeholders. You will lead program implementation, support workflow design and improvement, manage contract development activities, facilitate governance meetings, and monitor program performance to ensure successful outcomes. This position plays a key role in advancing integrated healthcare and social care models that improve health outcomes for vulnerable populations.

To be successful in this role, you'll bring experience building strong provider relationships, leading quality improvement initiatives, managing complex programs or projects, and collaborating across multiple stakeholders. Candidates with experience supporting vulnerable populations and familiarity with provider-facing technologies such as EHRs and Clinical Data Exchange platforms will be especially successful. An advanced degree in healthcare management, public health, business, or a related field is preferred.

Notes:

• A commitment to leveraging AI-enabled tools and technology to improve efficiency, streamline processes, and support continuous operational improvement.

Qualifications

• 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.
• 3 years of clinical experience or prior experience in public health, healthcare administration, or community health/outreach required.
• 3 years of experience directly related to HEDIS and/or Quality Improvement, with experience in data analysis and providing consultation and education to providers and provider staff required.
• For roles supporting the Patient-Centered Medical Home (PCMH) program, NCQA PCMH Content Expert Certification (CCE) is required.
• 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 services.

Requirements

• Must be able to travel up to 20% of the time.

Company Description

VSHP Volunteer State Health Plan, 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.