Network Hospital Quality Coordinator

Blue Cross & Blue Shield of Mississippi; United States; Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Highly competitive compensation package

Medical benefits

401(k) plan

Ample paid time off

Work-life balance

Job summary

Blue Cross & Blue Shield of Mississippi seeks a Network Hospital Quality Coordinator to enhance quality care for Mississippi residents. Responsibilities include reviewing key performance indicators and developing quality improvement programs aligned with regulatory standards.

The ideal candidate will have at least a Bachelor’s degree and five years of healthcare administration experience, with strong skills in data analysis and project management. A competitive compensation package and benefits are offered.

Qualifications

• Bachelor’s degree in a business-related field or clinical designation such as R.N.
• Five years of healthcare administration and/or clinical experience.
• Strong verbal and written communication skills.

Responsibilities

• Review data and KPIs to identify trends and areas for improvement.
• Develop and implement quality improvement projects.
• Ensure compliance with federal and state regulations.

Skills

Healthcare administration

Data analysis

Quality improvement project development

Interpersonal skills

Verbal communication

Written communication

Proficiency in Microsoft Word

Proficiency in Microsoft Excel

Education

Bachelor’s degree in a business-related field or clinical designation such as R.N.

Master’s degree in healthcare administration or nursing (preferred)

Tools

Microsoft Access

Microsoft Visio

Job description

Healthy Careers Start Here. Be part of a vision for a healthier Mississippi as a Network Hospital Quality Coordinator at Blue Cross & Blue Shield of Mississippi. The mission is to support Mississippi residents with quality healthcare and life‑long wellness.

Responsibilities

• Review data and key performance indicators (KPIs) to identify trends, benchmark against standards and pinpoint areas for improvement.
• Develop, implement and monitor quality improvement projects based on evidence‑based practices in alignment with the Comprehensive Quality Model (CQM) and value‑based initiatives.
• Ensure adherence to federal and state regulations and standards from organizations such as CMS and The Joint Commission.
• Conduct audit projects and develop corrective action plans for identified gaps.
• Research clinical care methods and best practices, recommending updates to measures that align clinical research and reimbursement programs.
• Present actionable data to improve performance, build trust and enhance the public brand.

Qualifications

• Bachelor’s degree in a business‑related field or clinical designation such as R.N.
• Five years of healthcare administration and/or clinical experience.
• Experience analyzing and trending healthcare‑related data.
• Experience in developing and implementing provider/hospital quality improvement programs.
• Proficiency in Microsoft Word and Excel.
• Ability to work on a flexible schedule with moderate travel.
• Working knowledge of healthcare quality as it relates to providers.
• Ability to analyze complex data sets to define and develop performance metrics.
• Proven ability to lead projects from conception to completion.
• Strong interpersonal skills to build business relationships with medical providers, frontline staff, and Blue Plans partners.
• High degree of accuracy and confidentiality management.
• Strong verbal communication skills to facilitate multidisciplinary meetings and continuous improvement.
• Clear written communication skills to ensure documentation and reports are accurate, detailed and use proper medical terminology.

Preferred Qualifications

• Master’s degree in healthcare administration or nursing.
• Experience with Microsoft Access and Visio.
• Knowledge of accreditation programs such as The Joint Commission, Det Norske Veritas (DNV) and National Committee for Quality Assurance (NCQA).
• Knowledge of value‑based programs such as Bundled Payments for Care Improvement (BPCI) and Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
• Knowledge of CPT, HCPCS, ICD10, Uniform Billing (UB) Revenue and National Drug Code (NDC) coding.
• Knowledge of High Reliability Organizations’ quality improvement methodologies and/or certification in quality process improvement.

Benefits

• Highly competitive compensation package that includes medical benefits, a 401(k) plan and ample paid time off.
• Work‑life balance with a schedule that supports personal wellness and professional growth.

Blue Cross & Blue Shield of Mississippi is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.