Clinical Quality Research Analyst

🕒 2 days ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔬 Research Analyst

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BlueCross BlueShield of Tennessee

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1952

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

BlueCross BlueShield of Tennessee is a leading health plan provider in Tennessee, serving 3. 4 million members. The company is committed to creating a workforce where everyone is valued, respected, and part of the team, emphasizing diversity and inclusion. They offer a range of career opportunities, including internships through their BlueBridge program, enabling new professionals to transition from college to work. BlueCross BlueShield of Tennessee also focuses on providing exceptional customer service and community care, striving to make a difference in the healthcare industry. It is an independent licensee of the Blue Cross Blue Shield Association and a qualified health plan issuer in the Health Insurance Marketplace.

📋 Description

• Perform quality and/or compliance audits to identify and address opportunities for improvement. • Coordinate Process Improvement based upon audit results. • Provide education and guidance on development of measures. • Provide consulting support for quality and compliance audits. • Use research experience and data analysis as tools for identifying existing potential healthcare and service opportunities for improvement and can design solutions for identified problems. • Educate internal customers on Quality Processes. • Analyze results for trends and identify areas of non-compliance.

🎯 Requirements

• 4 years - Managed care experience, or experience with regulatory or accrediting body requirements (i.e., URAC, NCQA, EQRO, and CMS) and Clinical Quality Improvement experience required • Certification as a Professional in Healthcare Quality, Lean Six Sigma Certification, or equivalent certification required, or must be attained within 1 year of hire. • Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint) • Excellent oral and written communication skills • Strong analytical skills

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible work hours • Paid time off