Blue Cross and Blue Shield of Minnesota · 1 month ago
Quality & Risk Adjustment Provider Consultant
Eagan, MN
Full-time
Hybrid
Senior Level
$89K/yr - $146K/yr
7+ years expBlue Cross and Blue Shield of Minnesota is dedicated to transforming healthcare and is seeking a Quality & Risk Adjustment Provider Consultant to support providers with value-based agreements. This role involves reviewing provider-specific data, leading meetings with provider care systems, and developing action plans to improve quality and coding accuracy performance.
Insurance
Responsibilities
Identifies 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 measures
Facilitates monthly discussions with provider group counterparts including reviewing relevant performance data and progress on action plan
Develops provider-facing materials on performance and opportunities
Serve as subject matter expert for providers regarding Quality measures and coding-accuracy performance
Qualification
Required
7+ 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 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, if not currently CPC or CCS-P
Experience successfully balancing multiple priorities or projects at the same time
Excellent verbal and written communication skills
Experience creating professional .ppt slides or other presentation materials
High School diploma (or equivalency) and legal authorization to work in the U.S
Preferred
Certification in healthcare quality such as Certified Profession in Healthcare Quality (CPHQ) or Certification in Health Care Quality and Manager (CHQM)
Registered Nurse
Benefits
Medical, dental, and vision insurance
Life insurance
401k
Paid Time Off (PTO)
Volunteer Paid Time Off (VPTO)
And more
Company
Blue Cross and Blue Shield of Minnesota
About Blue Cross Blue Cross and Blue Shield of Minnesota is a taxable, nonprofit organization with a mission to make a healthy difference in people’s lives.
1001-5000 employees
H1B Sponsorship
Blue Cross and Blue Shield of Minnesota has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (4)
2024 (4)
2023 (6)
2022 (2)
2021 (3)
2020 (5)
Funding
Current Stage
Late StageLeadership Team
Carrie S. Lawrence
Executive Administrator to the President & CEO and Chief of Staff
Patsy Riley
Chief Goverment Officer and Senior Vice President and CEO, ClearStone Solutions
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