Clinical Consultant

BlueCross BlueShield of Tennessee • Chattanooga, TN

1d • Remote

About The Position

The Clinical Consultant at BlueCross BlueShield of Tennessee is a strategic driver of clinical quality improvement, translating enterprise priorities into actionable initiatives to enhance quality of care for members, HEDIS, and overall quality performance. This role involves partnering with clinical, operational, and external stakeholders to assess performance, identify opportunities, design and implement interventions, and sustain measurable improvement. The Consultant applies sound clinical judgment, leverages multidisciplinary resources, and ensures consistent follow-up and accountability to achieve optimal outcomes while supporting enterprise goals. This is a fully remote role, and sponsorship is not available.

Requirements

• Bachelors Degree in Nursing with active RN license in the State of Tennessee or hold a license in the State of their residence if the State is participating in the Nurse Licensure Compact Law; or a Bachelors Degree in healthcare-related field
• 3 years - Clinical experience or prior experience in public health or community health / outreach
• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
• Proficient in Microsoft Office (Outlook, Word, Excel, Access and PowerPoint)
• Excellent oral and written communication skills

Nice To Haves

• Experience leading quality initiatives from planning through execution
• Ability to manage multiple priorities with strong attention to detail
• Comfortable presenting to varied audiences and influencing without authority
• Clinical background with Quality and/or HEDIS experience
• Strong analytical, technical, and digital skills
• Creative and adaptable; eager to responsibly leverage enterprise‑approved AI and technology to improve care and efficiency
• Strong interpersonal abilities

Responsibilities

• Assess effectiveness of and create and/or disband/combine clinically focused workgroups as appropriate to support the overall priorities and strategies for HEDIS and health outcomes.
• Manage clinical quality improvement studies, activities and projects; assist and support quality improvement studies, activities and projects.
• Participate in the development and implementation of new clinical projects to support continuous quality improvement; identify potential vulnerabilities and opportunities for improvement.
• Conduct evidence-based literature research to guide and support clinical quality improvement studies and activities; develop supporting presentations and coordinate with workgroups and project teams.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level