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 QualificationsEducation
- 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 Available1
Worker Type:Employee
Company:VSHP Volunteer State Health Plan, Inc
