Project Manager

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🕒 5 dias atrás

🐊 Florida – Remoto

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💵 $60.300 - $132.600 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👷‍♀️ Gerente de Projetos

👻 Score fantasma 0%

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Logo of CVS Health

CVS Health

10.000+ funcionários

Fundada em 1963

🏥 Saúde

⚕️ Seguro de Saúde

🛒 Varejo

Healthcare • Healthcare Insurance • Retail

CVS Health é uma empresa líder de saúde nos Estados Unidos, dedicada a ampliar o acesso e a acessibilidade ao cuidado. A empresa adota uma abordagem abrangente que inclui serviços de saúde, seguro saúde e gestão de benefícios farmacêuticos (PBM). Por meio de suas subsidiárias, como Aetna e CVS Caremark, a CVS Health oferece uma variedade de serviços que promovem o bem-estar, a gestão de condições de saúde e a cobertura acessível de medicamentos prescritos. A CVS Health opera farmácias de bairro, oferece serviços de farmácia por correspondência e gerencia programas de medicamentos de especialidade, com o objetivo de tornar o cuidado com a saúde conveniente e acessível para todos. Movida pela missão de conectar pessoas a serviços essenciais de cuidado, a CVS Health está comprometida em fomentar comunidades mais saudáveis e apoiar o bem-estar de todas as pessoas.

Descrição

• Manage third-party vendor operations, including SOW compliance, medical record abstraction, quality review, and special projects aligned with NCQA Technical Specifications • Oversee calibration of offshore and onshore record review practices, including HEDIS measure training, testing, abstraction, and documentation • Establish and maintain vendor processes for medical record intake, workflow alignment, and reporting results to providers • Support compliance and privacy-related coordination and negotiations involving vendor processes, record access, and operational workflows • Develop, update, and maintain documentation, training guides, and standard operating procedures • Monitor vendor SOW compliance, intake and abstraction analytics, and regular reporting and leadership updates • Partner with the Vendor Management Organization on SOWs, RFPs, staffing models, accounting considerations, and long-range workload forecasting • Coordinate offshore staffing activities, including onboarding review, background checks, Workday profile setup and updates, and staff transfers • Partner with Quality Management teams, Stars market partners, Engagement Managers, RN/PM specialists, and other stakeholders on audit readiness, research requests, special projects, and abstraction outcomes

🎯 Requisitos

• 3+ years of strong HEDIS measure experience and working knowledge of HEDIS technical specifications • 3+ years of experience managing HEDIS-related operations, medical record abstraction, quality review, or related healthcare quality initiatives • 2+ years of vendor management experience or equivalent • Ability to analyze information, support reporting, and monitor data integrity • Strong organizational skills and ability to manage multiple priorities in a fast-paced environment • Experience working across internal and external stakeholders to support operational execution and process improvement • Strong written and verbal communication skills • Proficiency in Microsoft Office applications, including Excel, PowerPoint, and Word • Ability to work EST due to areas covered • Project management experience in a vendor, healthcare, quality, or operational environment • Experience leading cross-functional projects involving vendors, data processes, and operational implementation • Experience with medical record exchange technologies, repository vendors, or regulated data workflows • PMP certification or formal project management training preferred • Bachelor’s Degree or Equivalent

🏖️ Benefícios

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program eligibility

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