Quality Research Analyst

BlueCross BlueShield of Tennessee • Nashville, TN

21h • Remote

About The Position

We are hiring a Quality Research Analyst at BCBST! In this role, you will support Population Health Management initiatives by collecting, validating, analyzing, and interpreting healthcare and operational data to drive improvements in member outcomes, quality performance, and organizational effectiveness. You will leverage advanced analytics, reporting tools, and AI-enabled technologies to identify trends, monitor key performance indicators, and uncover opportunities for intervention and process improvement. Working closely with cross-functional stakeholders, you will develop reports, dashboards, and actionable insights that support evidence-based decision-making, program evaluation, and strategic population health initiatives. To be successful in this role, in addition to the core job requirements, you'll bring strong analytical and problem-solving skills, experience working with complex datasets, and the ability to communicate data-driven insights to diverse audiences. Quality Improvement experience is required. You will be a strong candidate for this role if you have experience in healthcare analytics, population health, quality measurement, performance improvement initiatives, data visualization tools, statistical analysis, and leveraging AI-driven analytics to support scalable and efficient research and reporting outcomes. Preferred candidates will also have experience supporting or working within regulatory and accreditation frameworks, including URAC, NCQA, EQRO, and CMS requirements, and a demonstrated ability to use data and quality methodologies to drive compliance, performance improvement, and operational excellence.

Requirements

• Bachelor's Degree or equivalent work experience required. Equivalent experience is defined as 4 years of professional work experience in a corporate environment
• 5 years - Managed care experience, or experience with regulatory or accrediting body requirements (i.e., URAC, NCQA, EQRO, and CMS) and Quality Improvement experience required
• Demonstrated presentation and team facilitation skills
• Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)
• Excellent oral and written communication skills
• Ability to manage multiple projects and priorities
• Strong analytical and problem-solving skills
• Experience working with complex datasets
• Ability to communicate data-driven insights to diverse audiences
• Quality Improvement experience

Nice To Haves

• Experience in healthcare analytics
• Population health experience
• Quality measurement experience
• Performance improvement initiatives experience
• Data visualization tools experience
• Statistical analysis experience
• Leveraging AI-driven analytics to support scalable and efficient research and reporting outcomes
• Experience supporting or working within regulatory and accreditation frameworks, including URAC, NCQA, EQRO, and CMS requirements
• Demonstrated ability to use data and quality methodologies to drive compliance, performance improvement, and operational excellence

Responsibilities

• Coordinate and provide information to support quality improvement studies, initiatives and accreditation reviews.
• Ensure that all projects and departmental activities meet applicable regulatory and/or accrediting requirements.
• Coordinates multidisciplinary workgroups and committees that address and monitor quality activities and identifies noncompliance with standards.
• Coordinating and/or developing the annual documents (work plan, program description, program evaluation).

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree