Quality & Risk Adjustment Provider Consultant at Blue Cross Blue Shield of Minnesota

About Blue Cross and Blue Shield of MinnesotaAt Blue Cross and Blue Shield of Minnesota we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate you are joining a culture that is built on values of succeeding together finding a better way and doing the right thing. If you are ready to make a difference join us.The Impact You Will HaveThis role is a key element in Blue Cross support for providers with value-based agreements. The role reviews provider-specific data and identifies actionable opportunities for providers to improve their Quality and Coding Accuracy performance. The role leads face-to-face meetings with leaders in provider care systems and is responsible for developing and driving improvement via provider-specific action plans. The consultants are in-house subject matter experts on coding accuracy and Quality programs such as including HEDIS and Stars.Your Responsibilities As part of a Blue Cross provider-performance consultation team this roleIdentifies 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 improvement.Consult with providers on best practices to improve performance across Quality and Coding Accuracy measuresFacilitates monthly discussions with provider group counterparts including reviewing relevant performance data and progress on action planDevelops provider-facing materials on performance and opportunitiesServe as subject matter expert for providers regarding Quality measures and coding-accuracy performance.Required Skills and Experience7 years of related professional experience. All relevant experience including work education transferable skills and military experience will be considered.1 years of provider-facing or leadership-facing experienceKnowledge of Health Care Quality measuresCertified 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 if not currently CPC or CCS-PExperience successfully balancing multiple priorities or projects at the same time.Excellent verbal and written communication skillsExperience creating professional .ppt slides or other presentation materials.High School diploma (or equivalency) and legal authorization to work in the U.S.Preferred Skills and Experience Certification in healthcare quality such as Certified Profession in Healthcare Quality (CPHQ) or Certification in Health Care Quality and Manager (CHQM)Registered NurseRole DesignationHybridAnchored in ConnectionOur hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships creativity and alignment. The rest of the week you are empowered to work remote.Compensation and Benefits$88600.00 - $117400.00 - $146200.00 AnnualPay is based on several factors which vary based on position including skills ability and knowledge the selected individual is bringing to the specific job.We offer a comprehensive benefits package which may include:Medical dental and vision insuranceLife insurance401kPaid Time Off (PTO)Volunteer Paid Time Off (VPTO)And moreTo discover more about what we have to offer please review our benefits page.Equal Employment Opportunity StatementAt 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: Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.Required Experience:Contract Key Skills Access Control System,B2C,Business Analysis,Data Structures,Affiliate Marketing,Loans Employment Type : Full-Time Experience: years Vacancy: 1 Yearly Salary Salary: 88600 - 146200