Quality Incentive Consultant (Tennessee Based)

We are seeking a dedicated, experienced, and forward-thinking Quality Incentive Consultant to join BlueCross BlueShield of Tennessee.

In this role, the Quality Incentive Consultant serves as a strategic driver of quality and cost improvement, translating TennCare’s priorities into actionable initiatives that enhance quality performance, HEDIS outcomes, and overall care delivery for our members. This position partners closely with provider groups, clinical teams, operational leaders, and external stakeholders to assess performance, identify opportunities, and design and implement sustainable improvement strategies. The Consultant leverages data-driven insights, performance analytics, and cross-functional collaboration to ensure accountability and measurable results aligned with enterprise goals.

This role is ideal for a candidate who demonstrates:

• Proven experience leading quality or performance improvement initiatives from strategy through execution
• Strong organizational skills with the ability to manage multiple priorities and maintain attention to detail
• Confidence presenting to diverse audiences and influencing provider partners and stakeholders without direct authority
• Experience working with provider networks, quality metrics, and/or HEDIS (clinical background not required)
• Strong analytical, technical, and digital capabilities, with the ability to translate data into actionable insights
• A proactive, innovative mindset with a willingness to leverage enterprise-approved AI and technology to improve quality and efficiency

Additional Information:

• This is a fully remote position, although the team is based in Chattanooga, TN. Candidates must reside in the state of TN.
• Must be able to travel up to 20% of the time.
• Sponsorship is not available for this role.

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

BBEX 11; AEP

Number of Openings Available

Worker Type:

Company:

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.