Supports population health and quality improvement initiatives by collecting, validating, analyzing, and interpreting healthcare and operational data. Develops reports, dashboards, and actionable insights; coordinates quality studies, accreditation reviews, multidisciplinary workgroups, and compliance activities. Prepares annual work plans, program descriptions, and evaluations while identifying noncompliance and supporting performance improvement. Requires strong communication, presentation, facilitation, analytical, and project-management skills, along with managed care or regulatory experience.
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.
Note:
- This is a remote, work-from-home position.
- Sponsorship is not available for this role.
Job 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).
Job Qualifications
Education
- Bachelor's Degree or equivalent work experience required. Equivalent experience is defined as 4 years of professional work experience in a corporate environment
Experience
- 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
Skills\Certifications
- 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
Number of Openings Available
1Worker Type:
EmployeeCompany:
VSHP Volunteer State Health Plan, IncApplying 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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