Clinical Consultant

R-49267 We are seeking a dedicated, experienced, and forward‑thinking Clinical Consultant to join the team at BlueCross BlueShield of Tennessee In this role, the Clinical Consultant serves as a strategic driver of clinical quality improvement, translating enterprise priorities into actionable initiatives that improve quality of care for our members, HEDIS, and overall quality performance. Day to day, this role partners with clinical, operational, and external stakeholders to assess performance, identify opportunities, design and implement interventions, and sustain measurable improvement over time. 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 role is ideal for someone who offers the following capabilities and strengths:

  • 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 preferred
  • Strong analytical, technical, and digital skills
  • Creative and adaptable; eager to responsibly leverage enterprise‑approved AI and technology to improve care and efficiency
Note:
  • Although we are based in Chattanooga, TN, this is a fully remote role.
  • Sponsorship is not available for this position.
Job 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.
  • Effective 10/5/20: This Position requires a 24 month commitment before posting for other internal positions.
  Job Qualifications Education
  • 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
  Experience
  • 3 years - Clinical experience or prior experience in public health or community health / outreach required
  Skills\Certifications
  • 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
    Number of Openings Available 1  Worker Type: Employee  Company: BCBST BlueCross BlueShield of Tennessee, Inc.  Applying for this job indicates your acknowledgement and understanding of the following statements: BCBST will 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 any other characteristic protected by applicable law.   Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices   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.
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