Provider Quality Consultant

Job Responsibilities

• Interfaces with provider quality programs, as well as with other cross-functional programs across the Enterprise functioning as consultant on provider quality performance and improvement initiatives.
• Works closely in collaboration with multi-disciplinary member and provider facing teams to execute provider pay for quality programs which align goals to achieve high quality care.
• Conducts frequent face-to-face provider office visits and functions as subject-matter consultant on provider performance quality measures, reporting, and data.
• Drives and directs recommendations for action designed to achieve quality and productivity improvement goals.
• Provides education to internal as well as external stakeholders on best practices in delivering high quality care and functions as a liaison regarding quality support tools provided to stakeholders; looking beyond the purely “medical” issues confronting families.
• Must be able to travel up to 60% of the time.

Job Qualifications

Education

• Bachelor’s Degree in a Health Related Discipline (Nursing, Dietetics, Exercise Science, Counseling, Social work, Healthcare Administration, Public Health, or Health Education), or equivalent work experience required.

Experience

• 3 years – Clinical experience or prior experience in public health, healthcare administration, or community health / outreach required.
• 3 years – Experience directly related HEDIS and/or Quality Improvement, with experience in data analysis and providing consultation and education to providers and provider staff required.

Skills\Certifications

• Demonstrated presentation and team facilitation skills
• Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)
• Excellent oral and written communication skills
• Be organized, reliable, and able to manage multiple tasks with exceptional work ethic.
• Knowledge of Provider quality strategies, programs, and services

Employees who are required to operate either a BCBST-owned vehicle or a personal or rental vehicle for company business on a routine basis* will be automatically enrolled into the BCBST Driver Safety Program.   The employee will also be required to adhere to the guidelines set forth through the program.  This includes, maintaining a valid driver’s license, auto insurance compliance with minimum liability requirements; as defined in the “Use of Non BCBST-Owned Vehicle” Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR). *The definition for “routine basis” is defined as daily, weekly or at regularly schedule times.