Description: • Ensures the delivery of evidence-based care and services for members according to HFS quality strategy and ABHIL population health model • Directs analysis and reporting of member and provider data to monitor interventions and effectiveness • Plans, conducts and evaluates targeted member/provider initiatives and supports development of HEDIS interventions and initiatives within the Quality Management Team • Reviews documentation and interprets data from clinical records or systems to apply appropriate clinical criteria and policies in line with HEDIS, regulatory, and accreditation requirements • Works closely with the Quality team, leadership and POSC to drive population-based improvements in care and outcomes Requirements: • 5 years experience in managed care, clinical, or health care related field • 1 year of project management experience • Registered Nurse (RN) license in the state of their residence • Bachelors Degree required Benefits: • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching • Paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility Apply tot his job