Population Health Quality Specialist (HEDIS/NCQA)

CareFirst BlueCross BlueShield; Baltimore (MD); Hybrid; USD 48,168 - 95,667; Full time

Job summary

CareFirst BlueCross BlueShield is seeking an experienced professional in Baltimore/Washington for a position focused on promoting population health. This role requires delivering culturally appropriate health promotion information and includes hybrid work from home and at CareFirst locations.

Candidates should have a Bachelor’s degree and 3 years of relevant experience in public health or healthcare settings. The role involves member outreach, analyzing quality reports, and collaborating with healthcare providers to improve care outcomes.

The salary range for this position is $48,168 - $95,667, and candidates must be eligible to work in the U.S. without sponsorship.

Qualifications

• Minimum 3 years of experience in a business/public health environment.
• Experience in member and provider engagement is preferred.
• Certification in quality or process improvement methods desired.

Responsibilities

• Conduct member and provider outreach to close care gaps.
• Analyze claims data to improve member compliance.
• Collaborate with providers to manage member referrals for quality campaigns.

Skills

Engagement of health care consumers

Qualitative and quantitative data analysis

Healthcare claims knowledge

Fluency in Microsoft tools

Education

Bachelor’s Degree in relevant field

Tools

Microsoft Excel

Microsoft Word

Microsoft PowerPoint

Microsoft Outlook

Job description

CareFirst BlueCross BlueShield is seeking an experienced professional in Baltimore/Washington for a position focused on promoting population health. This role requires delivering culturally appropriate health promotion information and includes hybrid work from home and at CareFirst locations.

Candidates should have a Bachelor’s degree and 3 years of relevant experience in public health or healthcare settings. The role involves member outreach, analyzing quality reports, and collaborating with healthcare providers to improve care outcomes.

The salary range for this position is $48,168 - $95,667, and candidates must be eligible to work in the U.S. without sponsorship.