[Hiring] Senior Provider Performance Specialist @BlueCross BlueShield of Tennessee

Role Description

We are hiring a Sr. Provider Performance Specialist on our Provider Outreach and Innovation team at BCBST! In this role, you will support primarily eastern value-based provider groups, partnering directly with provider organizations to assess performance data, identify opportunities for improvement, and drive better quality, risk adjustment, and population health outcomes. You'll serve as a trusted advisor to providers, leveraging analytics, relationship management, and strategic problem-solving skills to help practices succeed in value-based arrangements while delivering measurable results for members and the organization. This position offers the opportunity to influence provider performance, strengthen partnerships, and support healthcare transformation through data-driven decision-making.

• This role supports primarily eastern value-based provider groups.
• Approximately 25% travel is required, primarily for occasional on-site provider visits.
• Sponsorship is not available for this role.

Qualifications

• Bachelor’s Degree in a Health-Related or Business-Related Discipline or equivalent work experience required.
• 4 years - Progressive experience in healthcare, quality improvement, or provider performance required.
• Demonstrated experience with risk adjustment, Quality programs (HEDIS, STARS, etc.), value-based care models, and incentive programs or MLR drivers.

Requirements

• Advanced healthcare data analysis and performance insight development.
• Expertise in risk adjustment, HEDIS/STAR quality programs, and value-based care models.
• Strong provider consulting and performance improvement capabilities.
• Knowledge of healthcare financial drivers including MLR and incentive structures.
• Ability to translate analytics into actionable provider strategies.

Company Description

BCBST BlueCross BlueShield of Tennessee, Inc. is committed to recruiting, hiring, training, and promoting 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.