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. This role involves translating enterprise priorities into actionable initiatives to enhance the quality of care for members, improve HEDIS scores, and boost overall quality performance. The consultant partners with clinical, operational, and external stakeholders to assess performance, identify improvement opportunities, design and implement interventions, and sustain measurable improvements. The role requires sound clinical judgment, leveraging multidisciplinary resources, and ensuring consistent follow-up and accountability to achieve optimal outcomes aligned with enterprise goals. The ideal candidate will have experience leading quality initiatives from planning through execution, strong attention to detail, comfort presenting to diverse audiences, and the ability to influence without authority. Strong analytical, technical, and digital skills are essential, along with creativity and adaptability, and an eagerness to responsibly utilize enterprise-approved AI and technology for care improvement and efficiency. This is a fully remote role, and sponsorship is not available for this position.

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 required
• 3 years - Clinical experience or prior experience in public health or community health / outreach required
• 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

• Clinical background with Quality and/or HEDIS experience preferred

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
• Number of Employees: 1,001-5,000 employees