Healthcare Quality & Performance Consultant

Health Care Service Corp.; Brooklyn Heights (TN); On-site; USD 42,000 - 93,000; Full time

Benefits offered by this job

Health benefits

401(k) savings plan

Pension plan

Paid time off

Paid parental leave

Disability insurance

Employee assistance program

Tuition reimbursement

Job summary

Health Care Service Corporation (HCSC) is seeking a Quality Analyst to perform trending analyses of quality results and coordinate QOC case intake, triage and tracking. The role includes drafting executive summaries, coordinating with internal partners, and focusing on improvement initiatives with adherence to regulatory standards.

The position requires strong communication, analytical, and organizational skills, plus experience in claims processing and quality management within the health

Qualifications

• Bachelor’s degree or 2 years’ claims-related experience or 6 years’ claims-related experience in health insurance.
• Strong problem-solving and customer service analysis.
• Familiarity with claims, inquiries, or membership processes and procedures.
• Experience leading meetings or small groups (1 year).
• Experience with quality assessment and process improvement.

Responsibilities

• Complete trending analysis of quality results and triage QOC cases.
• Draft executive summaries and case reports.
• Coordinate case intake and tracking across lines of business.
• Conduct audits and communicate quality program impacts to stakeholders.
• Maintain case documentation and reporting requirements.

Skills

Problem solving

Analytical thinking

Written communication

Verbal communication

Organization

Time management

Research

Critical thinking

Education

Bachelor’s degree

Associate degree

Tools

MHK

Facets

Salesforce Health Cloud

DentaQuest

EPIC

Job description

Health Care Service Corporation (HCSC) is seeking a Quality Analyst to perform trending analyses of quality results and coordinate QOC case intake, triage and tracking. The role includes drafting executive summaries, coordinating with internal partners, and focusing on improvement initiatives with adherence to regulatory standards.

The position requires strong communication, analytical, and organizational skills, plus experience in claims processing and quality management within the health