Supervisor, Clinical Quality Assurance

🔥 19 minutes ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🟠 Senior

🔴 Lead

🔒 Insurance

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BlueCross BlueShield of Tennessee

WebsiteLinkedInAll Job Openings

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

• Lead a high-performing team of nurses statewide. • Guide clinical reviews of medical records, partnering with provider offices to enhance documentation, strengthen patient education, and close gaps in care. • Play a key role in the annual HEDIS project through hybrid medical record reviews and supplemental data analysis. • Drive meaningful improvements in care quality by collaborating across teams. • Maintain and disseminate documentation and reports pertaining to quality and compliance issues, procedures, processes and methodologies. • Run database queries and apply logic to analyze complex issues, data, and performance measures. • Provide coordination and leadership of staff to ensure corporate compliance with accreditation and regulatory standards. • Stay abreast of changes in accreditation and regulatory requirements and take appropriate action.

🎯 Requirements

• Bachelors Degree in a Health Related Discipline (Nursing, Dietetics, Exercise Science, Counseling, Social work, or Health Education) • 2 years - Supervisory experience required • 5 years - Clinical nursing experience required • 2 years - Project management experience with demonstrated skills and successes • Certification as a Professional in Healthcare Quality, HIAA, or equivalent certification • Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.

🏖️ Benefits

• Health insurance • Retirement plans • Paid time off • Flexible work arrangements • Professional development opportunities