Project Manager

Job not on LinkedIn

🔥 9 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $60.3k - $132.6k / 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

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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