Note: The job is a remote job and is open to candidates in USA. BlueCross BlueShield of Tennessee provides healthcare services through its Volunteer State Health Plan organization. The Quality Research Analyst supports Population Health Management initiatives by analyzing healthcare and operational data, developing reports and dashboards, and identifying opportunities to improve member outcomes and quality performance. The role also supports quality improvement studies, accreditation reviews, regulatory compliance, and strategic population health initiatives.
Responsibilities
- Coordinate and provide information to support quality improvement studies, initiatives and accreditation reviews
- Ensure that all projects and departmental activities meet applicable regulatory and/or accrediting requirements
- Coordinates multidisciplinary workgroups and committees that address and monitor quality activities and identifies noncompliance with standards
- Coordinating and/or developing the annual documents (work plan, program description, program evaluation)
Skills
- To be successful in this role, in addition to the core job requirements, you'll bring strong analytical and problem-solving skills, experience working with complex datasets, and the ability to communicate data-driven insights to diverse audiences
- Quality Improvement experience is required
- You will be a strong candidate for this role if you have experience in healthcare analytics, population health, quality measurement, performance improvement initiatives, data visualization tools, statistical analysis, and leveraging AI-driven analytics to support scalable and efficient research and reporting outcomes
- * This is a remote, work-from-home position
- * Sponsorship is not available for this role
- * Bachelor's Degree or equivalent work experience required. Equivalent experience is defined as 4 years of professional work experience in a corporate environment
- * 5 years - Managed care experience, or experience with regulatory or accrediting body requirements (i.e., URAC, NCQA, EQRO, and CMS) and Quality Improvement experience required
- * Demonstrated presentation and team facilitation skills
- * Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)
- * Excellent oral and written communication skills
- * Ability to manage multiple projects and priorities
- Preferred candidates will also have experience supporting or working within regulatory and accreditation frameworks, including URAC, NCQA, EQRO, and CMS requirements, and a demonstrated ability to use data and quality methodologies to drive compliance, performance improvement, and operational excellence
Benefits
- Remote, work-from-home position
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