Provider Quality Consultant (Healthcare)

TL;DR

Provider Quality Consultant (Healthcare): Driving the implementation of the Health Starts initiative by serving as the primary liaison between provider groups and stakeholders with an accent on quality improvement and value-based care models. Focus on managing program performance, designing workflows, and optimizing provider outcomes for vulnerable populations.

Location: Remote (USA), based in or near Chattanooga, TN; requires up to 20% travel for office visits.

Company

hirify.global is a leading health insurance provider focused on advancing integrated healthcare and social care models.

What you will do

• Act as the primary liaison between participating provider groups, MCO partners, and TennCare stakeholders.
• Lead program implementation for the Health Starts initiative, including workflow design and improvement.
• Conduct virtual and face-to-face provider office visits to consult on performance quality measures and reporting.
• Execute provider pay-for-quality programs to align goals with high-quality care delivery.
• Provide education to internal and external stakeholders on best practices for integrated care.
• Apply expertise in value-based care delivery models (PCMH) and NCQA recognition programs.

Requirements

• Bachelor’s Degree in a health-related discipline (Nursing, Public Health, Healthcare Administration, etc.).
• Minimum 3 years of clinical experience or experience in public health/community health outreach.
• Minimum 3 years of experience directly related to HEDIS and/or Quality Improvement, including data analysis.
• Must be based in the USA and able to travel up to 20% of the time.
• Proficiency in Microsoft Office (Outlook, Word, Excel, PowerPoint).
• NCQA PCMH Content Expert Certification (CCE) is required for specific program support roles.

Culture & Benefits

• Commitment to leveraging AI-enabled tools to improve efficiency and operational processes.
• Focus on improving health outcomes for vulnerable populations.
• Collaborative, multi-disciplinary team environment.
• Commitment to equal opportunity employment (EEO).