CareFirst BlueCross BlueShieldColumbus, OH
- PURPOSE:The Population Health Strategy Consultant works closely with internal and external customers in CareFirst Community Health Plan District of Columbia to perform regulatory, accreditation and contractual oversight on quality.
- The Consultant collaborates with internal subject matter experts of relevant departments and stakeholder to provide consulting and advisory services to achieve program or contract goals.
- Performance Transformation: Employs consulting skills to manage behavior change and influence work flow improvements that optimize outcomes and value.
- Thoughtfully implements processes and technologies in business processes to assure the highest state of quality performance.
- Manages and track the risks associated with each requirement.
- Conducts a thorough review of stakeholders’ opportunities, data patterns, and outcomes to inform business decision making.
- Researches any variances and seeks resolution.
- Proactively manage the impact of proposed changes in performance patternsEffective Communication and Stakeholder Management: Builds and manages relationships with internal and external stakeholders.
- Identifies opportunities to improve the compliance of requirements and quality performance.
- Conduct proper education and training to the stakeholders to continuously foster the culture of quality.
- Facilitate relevant quality committees to ensure the effectiveness of quality governance structure.
- Active participation in best practice development and knowledge sharing, team activities, and administrative functions.
- Education Level: Master’s Degree in Public Health, Health Administration, Business Administration, or related field OR In lieu of a Master’s degree, an additional 6 years of relevant work experience is required in addition to the required work experience.
- Experience: 2 years health care experience.
- Consulting skills and/or direct experience in a consulting role.
- Experience in a clinical setting or knowledge in a clinically related field.
- Project management experience.
- Experience using Client Relationship Management (CRM) System(s).
- Knowledge, Skills and Abilities (KSAs)Demonstrated ability to effectively comprehend complex data analysis.
- Executive presentation skills.
- Effective written and interpersonal communication skills.
- Effective at building relationships with various levels of business professionals and/or clinicians.
- Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
- Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
- DC Medicaid – QualityEqual Employment Opportunity CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.
- It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
- Hire Range Disclaimer Actual salary will be based on relevant job experience and work history.
- Where To Apply Please visit our website to apply: www.
- carefirst.com/careersFederal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
- The associate is primarily seated while performing the duties of the position.
- Occasional walking or standing is required.
- The hands are regularly used to write, type, key and handle or feel small controls and objects.
- The associate must frequently talk and hear.
- Weights up to 25 pounds are occasionally lifted.
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