Specialty Care Physician to Participate on the our Clinical Quality Improvement Committee

Specialty Care Physician to Participate on the our Clinical Quality Improvement Committee

As the largest health insurer in Texas, Blue Cross and Blue Shield of Texas (BCSTX) serves more than 5 million members and processes millions of clinical claims each day. Even with those staggering numbers, we can’t lose focus on our core business promise – to make sure each member is covered when they need care, and that they are getting the best quality care available. Quality is at the core of how we do business.

We are currently looking for a specialty care physician to participate in our Clinical Quality Improvement Committee. The committee establishes priorities for the Quality Improvement (QI) Program, evaluates clinical and operational quality, and integrates QI activities.

The committee is comprised of seven external physicians who are in our network, and key internal BCBSTX department representatives. The committee provides guidance and direction to the QI program and promotion of the program goals and objectives.

Committee members will:

  • Provide guidance on quality management priorities and projects; make recommendations on the quality projects to undertake, and monitor progress in meeting goals
  • Reviewing QI program documents, such as the program description, work plan, and evaluation
  • Review and approve clinical practice guidelines, clinical review criteria, and wellness guidelines
  • Analyze and evaluate summaries and make recommendations for improvement. Report examples include:
  • Quality improvement studies and programs
  • Satisfaction surveys
  • Complaint and appeal review
  • Pharmacy, utilization management, and case management programs review
  • Review and approve recommendations and/or action plans provided by sub-committees

The ideal candidate will be a specialty care physician who is in network with BCBSTX. They must exhibit:

  • A sincere interest in making a difference in the lives of Texans
  • Strong communication skills
  • Strong goal-orientation
  • Assertive and comfortable contributing in virtual meetings

Meetings are held via WebEx from 6 to 8 p.m. on the third Thursday of the month. Committee members are required to attend at least nine meetings/year and external participants are compensated for their attendance.   

If you are qualified and interested, please contact us at SocialMediaTX@bcbstx.com.