BlueCross BlueShield of Tennessee
5001 - 10000 employees
Founded 1952
⚕️ Healthcare Insurance
Healthcare 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.
Clinical Quality Research Analyst
🕒 3 days ago
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BlueCross BlueShield of Tennessee
5001 - 10000 employees
Founded 1952
⚕️ Healthcare Insurance
Healthcare 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 • Coordinate Process Improvement based upon audit results • Provide education and guidance on development of measures • Consult for quality and compliance audits • Analyze results for trends and identify non-compliance areas
🎯 Requirements
• Current RN license • 4 years of managed care experience • Experience with regulatory or accrediting body requirements (i.e., URAC, NCQA, EQRO, CMS) • Certification as a Professional in Healthcare Quality, Lean Six Sigma Certification, or equivalent certification required • Proficient in Microsoft Office (Outlook, Word, Excel, and PowerPoint)
🏖️ Benefits
• Remote work opportunities • Professional development • Collaborative team environment • Flexible work arrangements
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