Senior Quality Specialist

Job not on LinkedIn

🔥 16 hours ago

🏈 Alabama, Arizona, +33 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🌶️ New Mexico – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – 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 ☕ Washington – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $18 - $38 / hour

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Act as an advocate and subject matter expert guiding the business as a quality champion • Measure and monitor the quality and effectiveness of claim processing and customer service work processes • Consult cross-functionally with other departments to influence and promote change • Perform regular quality audits for service operations across multiple products and platforms • Execute routine and non-routine business support tasks under limited supervision • Follow area protocols, standards, and policies • Serve as a subject matter expert on workflows, policies, systems requirements, enhancements, daily operations, and programs • Conduct standard quality reviews and audits to monitor compliance with published policies and procedures • Support targeted quality audit projects, report overall results, and recommend training needs, quality controls, and procedures to senior management • Execute assigned techniques, processes, and responsibilities

🎯 Requirements

• 2+ years of health insurance work experience and/or Healthcare Insurance Quality Review • 2+ years of experience working with diagnosis codes and medical terminology • Moderate to advanced knowledge of Excel, including V-lookups, pivot tables, and/or formulas • High School Diploma or equivalent GED • Working knowledge of problem solving and decision making skills • Claims experience • DG experience

🏖️ Benefits

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

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