Senior Project Manager – HEDIS

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Yesterday

🚗 Michigan – Remote

Although this job is listed in Michigan, this company may be open to hiring remote in other states.

💵 $67.9k - $199.1k / year

⏰ Full Time

🟠 Senior

👷‍♀️ Project Manager

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CVS Health

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Healthcare Insurance • Retail • Wellness

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

📋 Description

• Lead a team focused on HEDIS and Medicare Stars strategy and execution • Develop and maintain the master roadmap for HEDIS and Stars measures, ensuring alignment with enterprise goals and regulatory timelines • Provide strategic direction for HEDIS and Medicare Stars performance improvement, including gap closure initiatives, member engagement strategies, and provider collaboration • Mentor team members on quality management interventions, strategic planning, and performance analytics • Collaborate with internal departments (e.g., Clinical Operations, Data Analytics, Regulatory Affairs) to analyze data and lead data-driven initiatives that improve member outcomes and Stars ratings • Ensure implementation and monitoring of internal and external programs designed to impact member experience, clinical quality, and access measures • Drive operational efficiency and build scalable capabilities to support Stars and HEDIS performance • Prepare and deliver presentations for executive stakeholders, translating complex data and strategy into actionable insights • Foster a culture of teamwork, innovation, and accountability across the team and broader organization

🎯 Requirements

• 7-10 years of relevant work experience required • 2+ years of people management experience with multiple direct reports • Demonstrated success managing programs in a matrixed environment • Strong understanding of HEDIS and Medicare Stars measures, methodologies, and regulatory requirements • Exceptional interpersonal and stakeholder management skills • Advanced problem-solving and critical thinking abilities • Excellent communication skills, including experience preparing executive-level documents and presentations • Expertise in PowerPoint and Excel • Proven ability to adapt to change and align with evolving priorities • PMP (Project Management Professional) certification or equivalent preferred • Experience with CMS Stars strategy, NCQA reporting, or value-based care initiatives preferred • Familiarity with data visualization tools (e.g., Power BI, Tableau) and SQL preferred • CPHQ (Certified Professional Healthcare Quality) certification or equivalent preferred

🏖️ Benefits

• Affordable medical plan options • 401(k) plan (including matching company contributions) • 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