Senior Quality Management Specialist

Job not on LinkedIn

🔥 15 hours ago

🏈 Alabama, Arizona, +42 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ☕ Washington – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $47k - $122.4k / year

⏰ Full Time

🟠 Senior

👻 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 quality data, regulatory reporting, and analytics functions • Conduct literature reviews to assess quality initiatives and industry benchmarks • Design and develop dashboards and reporting solutions using tools such as Power BI and Tableau • Define and implement data models, statistical methodologies, and reporting frameworks • Translate analytical findings into business insights and support performance improvement • Perform quantitative and qualitative analyses for NCQA, HEDIS, Medicare Stars, and other quality metrics • Analyze intervention effectiveness, program impact, return on investment, and performance improvement • Partner with clinical, operations, and quality leadership on measure-level strategy • Identify performance gaps and prioritize and optimize interventions • Provide statistical analysis and evaluation support for regulatory reporting, including PIPs • Perform other duties as needed

🎯 Requirements

• 3+ years of experience with statistical analysis, including ability to analyze and interpret data • 3+ years of experience with Microsoft Office Suite, especially Microsoft Excel and PowerPoint • Experience with Tableau, SQL, and/or Power BI or similar dashboarding software • Previous experience in managed care or a similar healthcare environment that includes HEDIS preferred • Medicaid and/or Medicare managed care experience preferred • Ability to communicate with multiple internal and external stakeholders • Ability to collaborate effectively • Strong attention to detail • Ability to function successfully in an independent, self-driven environment • Excellent organizational and time management skills • Associate’s degree required • Bachelor’s degree or higher 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 • CVS Health bonus, commission or short-term incentive program in addition to base pay range