Remote Quality & Performance Consultant

HCSC Group; Nashville, Northern (TN, KY); Hybrid; USD 42,000 - 93,000; Full time

Job summary

HCSC is seeking a Quality and Performance Consultant to remotely analyze quality results and coordinate QOC case intake and triage across healthcare programs. You will draft executive summaries, report on performance, and collaborate with internal partners to address trends and quality concerns.

The role requires a bachelor’s degree (or higher) with 2 years of health insurance claims/benefits experience or 6 years in claims processing.

Qualifications

• Clear and concise written and verbal communication skills.
• Research, analytical, critical thinking and problem-solving skills.
• Organizational and time management skills.

Responsibilities

• Analyze quality results and trends for Quality of Care (QOC).
• Coordinate QOC case intake, triage, tracking, and assignment activities.
• Conduct audits across lines of business and draft executive summaries and reports.
• Facilitate meetings with internal partners and develop quality improvement solutions.
• Maintain case documentation and reporting requirements to show impact.

Skills

Communication skills

Analytical thinking

Problem solving

Organizational skills

Time management

Education

Bachelor's degree

Associate degree (preferred)

Job description

HCSC is seeking a Quality and Performance Consultant to remotely analyze quality results and coordinate QOC case intake and triage across healthcare programs. You will draft executive summaries, report on performance, and collaborate with internal partners to address trends and quality concerns.

The role requires a bachelor’s degree (or higher) with 2 years of health insurance claims/benefits experience or 6 years in claims processing.