Quality Incentive Consultant (Healthcare)

TL;DR

Quality Incentive Consultant (Healthcare): Driving quality and cost improvement initiatives by translating TennCare priorities into actionable strategies for HEDIS outcomes and care delivery. Focus on partnering with provider groups, analyzing performance data, and implementing sustainable improvement programs to ensure enterprise-wide quality goals.

Location: Must reside in the state of Tennessee (TN). This is a remote role with up to 60% travel required.

Company

hirify.global is a leading health insurance provider dedicated to improving the health and well-being of its members.

What you will do

• Collaborate with contracted providers to resolve data issues and improve quality program performance.
• Educate provider staff on clinical quality measures, reporting, and BCBST policies.
• Analyze performance data to identify opportunities for quality and cost improvement.
• Partner with clinical and operational teams to design and implement sustainable improvement strategies.
• Update policies and procedures to enhance the efficiency of quality programs.
• Present performance insights to diverse audiences and influence stakeholders without direct authority.

Requirements

• Must reside in the state of Tennessee (TN).
• Bachelor’s degree in a health-related discipline or equivalent experience.
• 4+ years of experience in quality improvement.
• 2+ years of experience in the healthcare industry.
• 1+ year of comprehensive knowledge in Medicare, HEDIS, and CMS Stars programs.
• Ability to travel up to 60% of the time.
• Proficiency in Microsoft Office suite.

Culture & Benefits

• Opportunity to work with a leading healthcare organization on high-impact quality initiatives.
• Collaborative environment focused on data-driven decision-making.
• Support for professional growth and innovation, including the use of enterprise-approved AI tools.
• Comprehensive benefits package typical of a major health insurance corporation.