Volunteer State Health Plan, Inc
Healthcare
ProviderQualityConsultant(TennesseeBased)
“Provider Quality Consultant (Tennessee Based) at Volunteer State Health Plan, Inc. Skills: Provider quality, Quality improvement, HEDIS, Data analysis. Serve as strategic driver of quality and cost. Translate priorities into actionable initiatives”
What You'll Achieve.
Enhance quality performance; Enhance HEDIS outcomes; Enhance overall care delivery; Achieve quality improvement goals; Achieve productivity improvement goals; Improve quality; Improve efficiency
Industry & Context.
Analytical capabilities; Translate data into actionable insights
Reside in the state of TN, Travel up to 20%
What They're Looking For.
Must Have
Bachelor's Degree or equivalent work experience, 3 years clinical experience or public health/healthcare administration/community health/outreach, 3 years HEDIS/Quality Improvement experience, Experience in data analysis, Experience providing consultation and education to providers and provider staff, NCQA PCMH Content Expert Certification required
Nice to Have
Clinical background not required
What You'll Do.
Serve as strategic driver of quality and cost
Translate priorities into actionable initiatives
Enhance quality performance
Enhance HEDIS outcomes
Enhance overall care delivery
Partner with provider groups
Partner with clinical teams
Partner with operational leaders
Partner with external stakeholders
Identify opportunities
Design improvement strategies
Implement sustainable improvement strategies
Leverage data-driven insights
Leverage performance analytics
Ensure accountability
Ensure measurable results
Interface with provider quality programs
Interface with cross-functional programs
Consult on provider quality performance
Consult on provider quality improvement
Collaborate with multi-disciplinary teams
Execute provider pay for quality programs
Align goals to achieve high quality care
Conduct provider office visits
Serve as subject-matter consultant on provider performance quality
Serve as subject-matter consultant on reporting
Serve as subject-matter consultant on data
Drive recommendations for action
Direct recommendations for action
Achieve quality improvement goals
Achieve productivity improvement goals
Provide education on best practices
Function as liaison regarding quality support tools
Exhibit knowledge of PCMH Model of Care
Exhibit knowledge of NCQA Recognition Program
Leverage enterprise-approved AI
Leverage technology to improve quality
Leverage technology to improve efficiency
How You'll Work.
Team & Collaboration
Provider groups; Clinical teams; Operational leaders; External stakeholders; Multi-disciplinary teams; Provider facing teams; Member facing teams; Internal stakeholders; External stakeholders
Communication Scope
Presenting to diverse audiences; Influencing provider partners; Influencing stakeholders; Oral communication; Written communication
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