Manager – Healthcare Quality, Project Management

Job not on LinkedIn

🔥 0 minutes ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

💵 $54.3k - $119.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👷‍♀️ Project Manager

👻 Ghost score 0%

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

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.

📋 Description

• Lead behavioral health population health initiatives for Louisiana Medicaid members • Conduct behavioral health population health assessments to identify priority populations, disparities, gaps in care, social drivers of health, utilization patterns, and improvement opportunities • Analyze claims, quality performance, utilization, member feedback, provider feedback, community data, and population health indicators • Develop, implement, and evaluate behavioral health components of the annual Population Health Management Strategy • Develop strategic recommendations addressing access, engagement, care coordination, quality outcomes, health equity, and behavioral health integration • Lead end-to-end Behavioral Health Performance Improvement Projects, including design, implementation, monitoring, evaluation, and reporting • Maintain project plans, timelines, risk logs, decision logs, evidence repositories, submission calendars, and reporting documentation • Coordinate quarterly, annual, and ad hoc PIP reporting and regulatory submissions • Monitor behavioral health quality measures including FUH, FUM, FUA, HEDIS, state, and organizational measures • Conduct root cause analyses, barrier analyses, and performance gap assessments • Prepare dashboards, scorecards, executive summaries, presentations, and reports • Present findings to leadership, quality committees, provider groups, state stakeholders, and other audiences • Develop provider education, member outreach, and engagement initiatives • Collaborate with community organizations, advocacy groups, healthcare providers, and vendor partners • Integrate health equity and social drivers of health into assessments and interventions • Support Louisiana Medicaid, regulatory, accreditation, NCQA, HIPAA, and organizational quality requirements • Maintain audit-ready documentation and support governance, committee, and strategic planning activities

🎯 Requirements

• Bachelor’s degree in Public Health, Population Health, Healthcare Administration, Behavioral Health, Psychology, Counseling, Social Work, Nursing, Health Sciences, Business Administration, Project Management, or a related field • Three or more years of experience in Healthcare Quality, Population Health, Behavioral Health, Medicaid Managed Care, Quality Improvement, Program Management, Project Management, or a related healthcare field • Experience leading complex cross-functional projects involving multiple stakeholders • Experience analyzing healthcare quality, utilization, population health, or clinical performance data • Experience developing and implementing quality improvement or population health interventions • Experience preparing presentations, reports, and recommendations for leadership audiences • Performance Improvement Project (PIP) Management • Quality Improvement Methodologies • Data Analysis and Performance Monitoring • Project Management • Root Cause and Barrier Analysis • Provider and Stakeholder Engagement • Executive Communication and Presentation • Cross-Functional Collaboration • Strategic Planning and Execution • Microsoft Office Suite and Collaboration Platforms

🏖️ Benefits

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