Senior Analyst, Clinical Quality

Job not on LinkedIn

🔥 0 minutes ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

💵 $47k - $91.8k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

👻 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

• Provide consultation based on analysis and identification of key drivers of results • Use data to identify clinical trends and analyze high-cost claimants, population health, and other clinical trends • Evaluate performance results and monitor engagement • Collaborate on opportunities for improvement • Establish and maintain engagement with large provider groups • Analyze provider performance metrics and clinical operations for value-based care readiness and risk assessment • Identify improvement areas and develop data-driven strategies to improve provider performance and financial rewards • Assess practice operations against industry best practices • Design and deliver training programs, workshops, and educational materials for providers and staff • Facilitate sessions on clinic operations, quality standards, regulatory compliance, member experience, and patient-centered care • Lead provider performance improvement initiatives and implement performance improvement plans • Monitor progress and evaluate intervention effectiveness with practice partners • Conduct audits, reviews, and assessments of provider practices, documentation, and compliance • Provide feedback and recommendations for improvement • Collaborate with clinical and operational leadership, value-based care, quality management, and provider relations teams • Foster effective relationships with providers and provide guidance, feedback, and support • Use data management systems and analytics tools to collect, analyze, and report provider performance data • Prepare reports, dashboards, and presentations for senior leadership • Track industry trends, best practices, and regulatory changes related to provider performance and healthcare quality • Support population health and health equity initiatives • Conduct research and benchmarking to identify innovative approaches and improvement opportunities

🎯 Requirements

• Prior experience in the healthcare industry • Prior clinical and/or managed care experience in the healthcare industry or quality management • 1–2 years relevant work experience • Experience developing presentations and working with data • HS Diploma/G.E.D minimum • Extensive Microsoft Excel experience preferred • HEDIS knowledge preferred • Certified Health Data Analyst (CHDA) preferred • Bachelor’s degree preferred • Ability to work 40 hours weekly

🏖️ 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