Clinical Quality Nurse Consultant - #309076

This job was posted by https://www.kansasworks.com : For more

information, please see: https://www.kansasworks.com/jobs/13617099 **Are

you ready to make a difference? Choose to work for one of the most

trusted companies in Kansas.**

• Why Join Us?**
• **Make a Positive Impact:** Your work will directly contribute to
  
  

the health and well-being of Kansans.

• **Family** **Comes First**: Total rewards package that promotes the
  
  

idea of family first for all employees. Paid vacation and sick leave

with paid maternity and paternity available immediately upon hire

• **Professional Growth Opportunities:** Advance your career with
  
  

ongoing training and development programs.

• **Dynamic Work Environment:** Collaborate with a team of passionate
  
  

and driven individuals in a work environment that promotes

flexibility.

• **Trust and Stability:** Work for one of the most trusted companies
  
  

in Kansas with over 80 years of commitment, compassion and

community.

• **Inclusive Work Environment:** We pride ourselves on fostering a
  
  

workplace where everyone is valued and respected.

**Benefits & Perks**

• Base compensation is only one component of your competitive Total
  
  

Rewards package

• Incentive pay program (EPIP)
• Health/Vision/Dental insurance
• 6 weeks paid parental leave for new mothers and fathers
• Fertility/Adoption assistance
• 2 weeks paid caregiver leave
• 401(k) plan matching up to 5%
• Tuition reimbursement
• Health & fitness benefits, discounts and resources
  
  

**Job Summary**

The Clinical Quality Nurse Consultant serves as a clinical liaison

between Blue Cross Blue Shield of Kansas (BCBSKS), providers, and

members to support quality improvement, care coordination, and

value-based care initiatives across all lines of business. This role

partners with providers and internal teams to implement data-informed

clinical processes, improve quality outcomes, and support regulatory and

accreditation requirements. The Nurse Consultant provides clinical

expertise in quality measurement, HEDIS performance, and care

coordination while advancing organizational goals related to quality,

affordability, and member experience. This position reports to the

Manager, Clinical Quality & Accreditation.

\"This position is eligible to work remotely, hybrid or onsite in

accordance with our Telecommuting Policy. Applicants must reside in

Kansas or Missouri or be willing to relocate as a condition of

employment.\"

**What you\'ll do**

• Support clinical quality improvement and value-based care
  
  

initiatives by partnering with providers and internal teams to

improve quality outcomes across assigned populations and lines of

business.

• Provide clinical expertise related to quality measurement, including
  
  

HEDIS metrics, care coordination strategies, and performance

improvement activities.

• Collaborate with provider offices to implement workflows, tools, and
  
  

processes that support population health management, care

coordination, and quality gap closure.

• Participate in quality oversight activities, including medical
  
  

record reviews and peer review processes, serving as a clinical

resource for committees such as the Administrative Quality Committee

(AQC) as assigned.

• Prepare and contribute to quality reports, summaries, and
  
  

presentations supporting departmental, divisional, and corporate

quality objectives.

• Collaborate with cross-functional teams to identify trends,
  
  

opportunities, and educational needs related to quality measurement

and clinical performance.

• Support compliance with applicable regulatory and accreditation
  
  

standards as part of routine clinical quality activities.

• Serve as a clinical resource for internal staff, providers, and
  
  

external partners related to quality improvement programs and care

coordination s lutions.

• Contribute to the development and maintenance of policies,
  
  

procedures, and training materials supporting clinical quality

improvement and reporting activities.

**What you need**

Knowledge/Skills/Abilities

• Strong clinical knowledge and understanding of quality improvement
  
  

principles and healthcare delivery systems.

• Ability to communicate effectively with providers, internal
  
  

stakeholders, and external partners.

• Ability to work independently, prioritize work, and adapt to
  
  

changing priorities.

• Ability to analyze clinical information and identify trends or
  
  

improvement opportunities.

• Working knowledge of provider practice patterns, utilization, and
  
  

care coordination models.

• Understanding of business continuity and departmental recovery
  
  

expectations.

Education And Experience

Associate Degree in Nursing (ADN) required. Bachelor\'s in nursing or

health related field preferred.

Current unrestricted Kansas Registered Nurse (RN) licensure required.

Minimum of 5 years of RN clini