QM Nurse Consultant

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🔥 15 minutes ago

⚔️ Virginia, West Virginia – Remote

⚔️ Virginia – Remote ⛰️ West Virginia – Remote

💵 $54.1k - $142.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💼 Consultant

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

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.

📋 Description

• Applies specialized clinical knowledge to participate in quality improvement efforts to assess and enhance patient care. • Collaborates with the healthcare quality team to collect and analyze clinical data, participate in quality reviews, and identify opportunities for process improvement. • Provides insights and recommendations to optimize healthcare practices and promote patient safety and satisfaction. • Strengthens WV Medicaid’s ability to improve member outcomes through clinically guided, member-centric quality interventions. • Applies clinical judgement to guide quality initiatives, prioritize member engagement, and support adherence to evidence-based care.

🎯 Requirements

• 3-5 years of prior relevant work experience • Active Registered Nurse (RN) required • Certified Professional in Healthcare Quality (CPHQ) preferred • Experience with clinical or quality improvement and process improvement • Manage care experience preferred • Experience working with the Medicaid population • Bachelor's degree preferred/specialized training/relevant professional qualification

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • comprehensive benefits package