BlueCross BlueShield of Tennessee PCMH Data Consultant in Nashville, Tennessee

The PCMH Data Consultant is responsible for all related duties involving analytic reporting, included but not limited to tracking and trending of statewide program performance, as well technology training for PCMH staff. Incumbent will be responsible for pulling reports for the joint operations committee (JOC) meetings and population health outreach initiatives.

Job Description:

Job Duties & Responsibilities

  • Manage special projects and initiatives as assigned by PCMH management team.
  • Seeks out opportunities to leverage standard and/or ad-hoc reporting and analysis to review past performance in quality and cost to influence outcomes related to quality, access, cost, and utilization of healthcare to BCBST members participating in the PCMH program.
  • Develops and maintains policies, procedures, and training materials for Quality Care Partnership on PCMH SharePoint site.
  • Team lead for the development of all care coordinator productivity reports and provider reports; provide potential recommendations to leadership based on findings.
  • Identifies key problems, determines root cause, and recommends consistent quality improvement solutions.
  • Interprets data into actionable information; provide proactive investigation into results and explore opportunities for improvement through PCMH practice workflow redesign through collaboration with all relevant areas.
  • Facilitates statewide technology training to include creation of training materials, as well as conducting and coordinating new user training on all Value Based Technology platforms.
  • Serves as technical lead between BCBST and application vendors, as well as between BCBST and provider staff; analyzes technical issues and problems across the state.
  • Proactively partners with all internal and external stakeholders to assess practice needs and provides clinical reporting and analytic solutions that best meet those needs. Supports the PCMH team with annual HEDIS audit, and compiles and reviews final documents to ensure a passing score for the PCMH program.
  • Works closely with Data Integration, internal BCBST Facets team, and Contracting and serves as the Data Consultant for PCMH management to maintain an accurate provider registry for all PCMH contracted practices
  • Builds partnerships and collaborates with key stakeholders in visualizing, articulating, and implementing the new PCMH reporting package to be reviewed at the PCMH Quarterly meetings.
  • Responsible for the maintenance of new employee Onboarding Toolkits for the Quality Care Partnership team.
  • Position requires some travel
  • Other duties as assigned by management.

Job Qualifications

Education

  • Bachelor’s degree or equivalent work experience required. Equivalent experience is defined as 4 years of professional work experience.

Experience

  • 5 years’ of progressive work related experience such as IT, medical informatics, and project management in the healthcare industry required
  • Demonstrated project management/analytic experience in the healthcare setting required

Skills/Certifications

  • Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
  • Excellent oral and written communication skills.
  • Strong interpersonal and organizational skills
  • Must be a team player, be organized and have the ability to handle multiple projects
  • Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles, and accountability
  • Ability to manage multiple assignments with critical deadlines while achieving quality results required.
  • Proven analytical, interpretive, evaluative, and problem-solving skills

Job Specific Requirements:

Number of Openings Available:

1

Worker Type:

Employee

Worker Sub-Type:

Regular

Company:

BCBST BlueCross BlueShield of Tennessee, Inc.

BCBST is an Equal Opportunity employer (EEO), and all employees and applicants will be entitled to equal employment opportunities when employment decisions are made. BCBST will take affirmative action to recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or membership in a historically under-represented group.

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

Tobacco-Free Hiring Statement

To further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products in any form in Tennessee and where state law permits. A tobacco-free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a tobacco/nicotine test. An individual whose test result is positive for tobacco/nicotine will be disqualified from employment and the job offer will be withdrawn. Individuals who fail the tobacco/nicotine screening will be permitted to reapply for employment after 6 months, iftobacco/nicotine-free.

Resources to help individuals discontinue the use of tobacco/nicotine products include smokefree.gov or 1-800-QUIT-NOW.

About Us

As Tennessee's largest health benefit plan company, we've been helping Tennesseans find their own unique paths to good health for over 65 years. More than that, we're your neighbors and friends – fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow.