Kimberlie Mozes, MBA, MSN, RN CPHQ
Senior Consultant, Clinical
Kimberlie has 26 years of clinical experience in acute care and managed care organizations. Her areas of expertise include HEDIS and STAR rating improvement through process and quality implementation, state regulatory and accreditation compliance of CMS quality performance measures, medical management and utilization management process redesign, clinical subject matter expertise for the development and implementation of integrated behavioral and physical health contracts, policy and procedure review and development to meet all regulatory and compliance guidelines, and care management and disease management program development and implementation.
Kimberlie’s prior experience includes the Administrator for Healthcare Services for the Division of Developmental Disabilities (DDD) for the State of Arizona where she managed and oversaw the state Medicaid contract for DDD. She also provided consultative services to ACOs and provider groups for HEDIS and STAR quality improvement for the Medicare Advantage population for Optum.
Kimberlie holds an MBA in Healthcare Management, an MSN in Informatics, and a BS in nursing from Western Governors University in Utah. She has been recognized as a Certified Professional in Healthcare Quality (CPHQ) from the National Association for Healthcare Quality (NAHQ). She is currently pursuing a Doctor of Health Administration in Quality Analytics at Capella University where she was recognized for academic excellence.