Quality & Risk Adjustment Provider Consultant

Quality & Risk Adjustment Provider Consultant

Blue Cross and Blue Shield of Minnesota is seeking a dedicated and motivated individual to join our team as a Quality & Risk Adjustment Provider Consultant. This role plays a key part in supporting providers with value-based agreements by reviewing provider-specific data, identifying actionable opportunities, and driving improvement through provider-specific action plans.

• Identify opportunities for provider groups to improve performance on quality and coding accuracy.
• Develop and drive provider-specific action plans to improve quality and coding accuracy performance.
• Consult with providers on best practices to improve performance across quality and coding accuracy measures.
• Facilitate monthly discussions with provider group counterparts to review relevant performance data and progress on action plans.
• Develop provider-facing materials on performance and opportunities.
• Serve as subject matter expert for providers regarding quality measures and coding-accuracy performance.

• 7+ years of related professional experience.
• 1+ years of provider-facing or leadership-facing experience.
• Knowledge of health care quality measures.
• Certified Risk Adjustment Coder (CRC via AAPC) or Certified Professional Coder (CPC via AAPC). If you do not have both the CRC AND CPC, it will be required to obtain both AAPC certifications within the first year in position (CRC within 6 months of hire and CPC within 1 year of hire).
• Experience successfully balancing multiple priorities or projects at the same time.
• Excellent verbal and written communication skills.
• Experience creating professional presentation materials.
• High school diploma (or equivalency) and legal authorization to work in the U.S.

• Certification in healthcare quality such as Certified Professional in Healthcare Quality (CPHQ) or Certification in Health Care Quality and Manager (CHQM).
• Registered Nurse.

Pay Range: $88,600.00 - $ - $ Annual
Benefits:

• Medical, dental, and vision insurance
• Life insurance
• 401k
• Paid Time Off (PTO)
• Volunteer Paid Time Off (VPTO)
• And more

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an affirmative action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talen Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.

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