• Lead Abstractor, HEDIS /Quality Improvement…

    Molina Healthcare (Chandler, AZ)
    …Lead Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The ... + Performs the lead role in the coordination and preparation of the HEDIS medical record review which includes ongoing review of records submitted by providers… more
    Molina Healthcare (08/08/25)
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  • Risk & Quality Performance Manager (Remote)

    Molina Healthcare (Mesa, AZ)
    **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success. * Partner with other teams to ensure data quality… more
    Molina Healthcare (07/31/25)
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  • Health Plan Pharmacy Services Manager (SC…

    Molina Healthcare (AZ)
    …position requires a current South Carolina pharmacist license **Job Summary** The Pharmacy Manager , Health Plan Pharmacy Services is an integral role of the Health ... and Health Education programs including, but not limited to, NCQA Accreditation, HEDIS , and Disease Management programs company wide. + Attends State and Health… more
    Molina Healthcare (07/24/25)
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  • Senior Client Coding Project Manager

    Datavant (Phoenix, AZ)
    …to realize our bold vision for healthcare. As a Sr. Client Coding Project Manager , you will plan, forecast, and manage client-facing coding projects. You will work ... + Previous Medicare Advantage Risk Adjustment, CDI, Medicaid, Commercial RA, and HEDIS experience. + Familiarity with HIPAA patient privacy requirements. + Excellent… more
    Datavant (06/28/25)
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  • Quality RN Professional

    CenterWell (Peoria, AZ)
    …across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements + Financial performance and ... state + 5+ years of clinical nursing experience + Proven work experience as a HEDIS Nurse or similar role in healthcare quality improvement + Strong knowledge of … more
    CenterWell (07/08/25)
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  • Consultative Coding Professional

    CenterWell (Phoenix, AZ)
    …opportunities. + Perform individual chart research as requested. + Collaborate with HEDIS leaders and champions to identify HEDIS gaps and deficiencies. ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
    CenterWell (08/08/25)
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  • WIC Quality Assurance Specialist

    Adelante (Phoenix, AZ)
    …to enhance service delivery. This position will work with the Nutrition Services Manager , WIC Services Manager and Director of WIC to identify opportunities ... degree + Experience in managed care with knowledge of HEDIS and STARS Quality Metrics preferred + Quality Assurance...Collaborates with the Quality Director and the Quality Assurance Manager (QAM) on the development and implementation of the… more
    Adelante (06/30/25)
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  • Supervisor, Clinical Pharmacy/MTM - Remote

    Molina Healthcare (Mesa, AZ)
    …Medicaid eligible members as well as Medication Adherence Programs for STAR, HEDIS and behavioral health medications. * Ensures that adequate staffing coverage is ... to determine which recommended changes to drug therapy were implemented. * Assists Manager or Director in the collection and tabulation of data for reporting… more
    Molina Healthcare (08/08/25)
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  • Registered Nurse (Family/Internal Medicine)

    Adelante (Goodyear, AZ)
    …Delivery Integration and closure of Healthcare Effectiveness Data & Information Set ( HEDIS ) care gaps of required Quality Metrics. + Coordinate outreach efforts to ... Plans. + Other projects as requested by the Nursing Manager , Quality Improvement Manager , or Director of Quality NON-ESSENTIAL SKILLS AND EXPERIENCE: +… more
    Adelante (07/04/25)
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  • Clinical Performance Liaison

    Dignity Health (Phoenix, AZ)
    …teams within Arizona Care Network (ACN). ACN CPLs report to the Manager of Practice Transformation within the Clinical Performance Department, and are responsible ... metrics commonly tied to performance in value based contracts (CMS ACO, HEDIS , NCQA, etc.) and Medicare Advantage programs (HCC/RAF). In addition these positions… more
    Dignity Health (07/03/25)
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