Senior Quality Specialist

Job not on LinkedIn

🔥 12 hours ago

❄️ Minnesota – Remote

❄️ Minnesota – Remote

💵 $18 - $38 / hour

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Act as a quality champion and subject matter expert for claim processing and customer service processes • Measure and monitor quality and effectiveness of work processes impacting customer satisfaction, medical cost management, and operational efficiency • Consult cross-functionally to influence and promote change and deliver quality service to internal and external customers • Perform regular quality audits for service operations across multiple products and platforms • Execute routine and non-routine business support tasks under limited supervision • Follow area protocols, standards, and policies • Support Quality Specialist workflows, policies, system requirements, enhancements, daily operations, and programs • Conduct quality reviews and audits to monitor compliance with published policies and procedures • Support targeted quality audit projects, report results, and recommend training needs, quality controls, and procedures to senior management • Execute assigned techniques, processes, and responsibilities

🎯 Requirements

• 2+ years of health insurance work experience and/or Healthcare Insurance Quality Review • 2+ years of experience working with diagnosis codes and medical terminology • Moderate to advanced knowledge of Excel, including V-lookups, pivot tables, and/or formulas • High School Diploma or equivalent GED • Working knowledge of problem solving and decision making skills • Claims experience • DG experience • College degree preferred

🏖️ Benefits

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

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