Value-Based Provider Performance Leader

bcbst; Chattanooga (TN); On-site; USD 85,000 - 125,000; Full time

Job summary

BCBST BlueCross BlueShield of Tennessee, Inc. seeks aSr.

Provider Performance Specialist on our Provider Outreach and Innovation team in Chattanooga to partner with eastern value-based provider groups, assess performance data, and drive improvements in quality, risk adjustment and population health outcomes. You will translate analytics into strategic guidance for providers, influence incentive programs, and collaborate with internal stakeholders to support regulatory requirements and

Qualifications

• Bachelor’s degree required in health-related or business discipline, or equivalent experience.
• 4 years of progressive healthcare, quality improvement, or provider performance work experience.

Responsibilities

• Support provider performance strategies across risk adjustment, quality measures, MLR, and value-based care.
• Analyze provider and population data to identify gaps and improvement opportunities.
• Develop and help implement action plans with data segmentation and targeted gaps closure.
• Educate providers on quality expectations, program requirements, documentation, and coding accuracy.
• Align and optimize incentive programs to maximize provider engagement.
• Use dashboards and tools to track quality performance and engage providers.
• Ensure consistent execution of performance initiatives across provider groups.
• Collaborate with internal stakeholders to align strategies with regulatory requirements and value-based initiatives.

Skills

Advanced healthcare data analysis

Risk adjustment

HEDIS/STAR quality programs

Value-based care models

Provider consulting and performance

Translating analytics into actions

Education

Bachelor's Degree in Health-Related or Business-Related Discipline or equivalent work experience

Job description

BCBST BlueCross BlueShield of Tennessee, Inc. seeks aSr.

Provider Performance Specialist on our Provider Outreach and Innovation team in Chattanooga to partner with eastern value-based provider groups, assess performance data, and drive improvements in quality, risk adjustment and population health outcomes. You will translate analytics into strategic guidance for providers, influence incentive programs, and collaborate with internal stakeholders to support regulatory requirements and