Job Description
We are seeking a dedicated, experienced, and forward-thinking Provider Quality Consultant to join BlueCross BlueShield of Tennessee . In this role, the Provider Quality Consultant serves as a strategic driver of quality and cost improvement, translating TennCare’s priorities into actionable initiatives that enhance quality performance, HEDIS outcomes, and overall care delivery for our members. This position partners closely with provider groups, clinical teams, operational leaders, and external stakeholders to assess performance, identify opportunities, and design and implement sustainable improvement strategies. The Consultant leverages data-driven insights, performance analytics, and cross-functional collaboration to ensure accountability and measurable results aligned with enterprise goals. This role is ideal for a candidate who demonstrates: Proven experience leading quality or performance improvement initiatives from strategy through execution Strong organizational skills with the ability to manage multiple priorities and maintain attention to detail Confidence presenting to diverse audiences and influencing provider partners and stakeholders without direct authority Experience working with provider networks, quality metrics, and/or HEDIS (clinical background not required) Strong analytical, technical, and digital capabilities, with the ability to translate data into actionable insights A proactive, innovative mindset with a willingness to leverage enterprise-approved AI and technology to improve quality and efficiency Additional Information: This is a fully remote position, although the team is based in Chattanooga, TN. Candidates must reside in the state of TN. Must be able to travel up to 20% of the time. Sponsorship is not available for this role. NCQA PCMH Content Expert Certification required. Job Responsibilities Interfaces with provider quality programs, as well as with other cross-functional programs across the Enterprise functioning as consultant on p
