Job Description

Awarded the Best Place to Work 2021, Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

This position, with minimal supervision, is responsible for leading activities that support quality initiatives related to service delivery to members, provider interface, documentation retrieval and Federal and State mandated reporting.


Required Work Experience
  • 1 year of experience with HEDIS, CAHPS, and HOS programs as defined by CMS. Health information management or comparable field
  • 1 year of experience working healthcare or health insurance

Required Education

  • High school diploma or GED in general field of study.

Required Licenses

  • N/A

Required Certifications

  • N/A


Preferred Work Experience

  • 2 years of experience of business analysis or a related area preferred.
  • 1 year of Experience in Quality Management, Medicare Management, or Health Care a plus.

Preferred Education

  • N/A

Preferred Licenses

  • N/A

Preferred Certifications

  • N/A


  • Works with Registered Nurse on obtaining information required for Quality of Care case reviews.
  • Work with team leads in activities to improve Healthcare Effectiveness Data and Information Set (HEDIS), Consumer Assessment of Healthcare Providers & Systems (CAHPS), and Health Outcomes Survey (HOS) related services.
  • Responsible for accomplishing assigned tasks and ensuring established timelines are met.
  • Works with variety of professionals, both internal and external to Blue Advantage, to obtain information/documentation in support of Quality Management activities.
  • Responsible for validating the quality of information stored in various Quality Management systems to ensure accuracy and completeness.
  • With guidance of experienced analysts and/or nurses, will analyze business and staff needed, obtain information as required, and document results of activities.
  • Assists with development of or enhancement of processes to better meet changing goals and requirements of the Quality Management Department.
  • Maintains database information as assigned. This includes data entry, reconciliation of data, validation of data integrity, and production of reports.
  • Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers with an excellent service experience by consistently demonstrating our core behaviors each day.
  • The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
  • Perform all other duties as assigned.



Required Job Skills

  • Basic skill with Microsoft Office products (Word, Excel, Access, PowerPoint) as well as data systems used by BCBSAZ and its contracted companies.

Required Professional Competencies

  • Able to maintain multiple projects with varying levels of complexity and scheduling limitations. Strong organizational skills as well as excellent oral and written communication abilities.
  • Familiarity with information technology areas, such as personal software packages, to generate reports and present information in a written or spreadsheet format.
  • Excellent oral and written communication skills to effectively interact with internal and external customers and department staff.
  • Ability to organize, prioritize, and manage a variety of tasks and activities in a timely and effective manner.
  • Quickly assimilate new activities and provide support to department staff in performing project-related work in timely manner.

Required Leadership Experience and Competencies

  • N/A


Preferred Job Skills

  • N/A

Preferred Professional Competencies

  • N/A

Preferred Leadership Experience and Competencies

  • N/A

Our Commitment

BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona.  For more information on our company, see  If interested in this position, please apply.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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