Job Description

The Administrative Performance Improvement Specialist is responsible for quality improvement activities and projects related to improving operational and system-wide performance. The position will collaborate with internal departments, provider network agencies, internal and external stakeholders and state agencies in all aspects of the performance and quality improvement program. Accountable to ensure positive outcomes and compliance with contractual requirements and federal and state behavioral and physical health regulations and policies. Responsible to link quality Improvement activities to business goals, values and strategies. Analyzes areas of deficiency and orchestrates performance improvement of quality performance measures throughout the organization and provider network.



  • Develops and implements operational and administrative quality improvement projects aligned with Quality Improvement Work Plan goals and company values.
  • Manages internal and external provider monitoring functions to ensure compliance with outcome measures, applicable regulations, policies and protocols, and clinical best practices.
  • Serves as a project manager and coordinator for accreditation survey readiness preparation.
  • Responds to ad-hoc requests for quality improvement or performance related information by state agencies and internal customers.
  • Serves as a quality improvement resource, and coaches internal customers, provider network staff, and stakeholders on performance improvement tools and methods. 
  • Collaborates with Quality Data Analysts to develop, analyze, track, trend, and improve internal reporting and ADHS deliverables including but not limited to: AHCCCS/ADHS performance measures, EPSDT tracking, member and provider outreach activities, ADHS administrative review activities, AHCCCS/ADHS Performance Improvement Projects, system-wide corrective action plans, provider appointment availability and timeliness standards.
  • Monitors and analyzes internal and provider performance data from multiple sources to identify and respond to emerging trends and to ensure compliance with minimum standards and improve member outcomes.
  • Oversees identification and development of performance improvement opportunities and strategies, technical assistance and enforcement activities.
  • Conducts research, reviews, analyzes and compiles data, develops recommendations and reports.
  • Participates in internal and external committees and work groups.
  • Participates in or collaborates with HCIC committees, projects and work teams.
  • Performs other duties of a similar nature and level as assigned.



Equal Opportunity Employer Minorities/Women/Veterans/Disabled



Bachelor's degree or equivalent experience in health care, business, or related field required

Three (3) or more years of operational or clinical healthcare quality management or related experience

National Committee for Quality Assurance (NCQA) and Health Care Effectiveness and Data and Information Set (HEDIS) experience

Six Sigma Green Belt certification, experience with Lean and Six Sigma team facilitation, and basic knowledge of statistics and data analysis tools

Certified Professional in Healthcare Quality (CPHQ) desirable

Proficiency in developing and presenting analytic reports (writen and verbal), data collection, sampling, analysis, and presentation

Excellent communication and collaboration skills

Excellent customer service and oral / written communication skills

Demonstrated attention to detail and accuracy

Demonstrated organizational skills

Excellent problem solving, information / research skills

Ability to use electronic word processing, email, and electronic database resources

Ability to multitask projects and issues on fixed timelines

Some tavel is required

Valid Arizona drivers license

Application Instructions

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