Health Care Quality Management Specialist (Remote-Must Reside in FL)

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

The Health Care Quality Management Analyst implements a quality management strategy that meets internal and external constituent expectations for demonstrating quality outcomes, including NCQA and state regulators for Medicaid and CHIP.  Links the quality management activities to business goals by using innovation, integration, and information. Participates in the development and ongoing implementation of Quality Management (QM) work plans and activities, including support of all accreditation activities and contract requirements.

What you will do

• Support accreditation minimally for health plan, health outcomes, and long term supports and services.
• Support quality contract requirements, including performance improvement projects, analysis of quality improvement activities, and quality program evaluation.
• Assists in the development and implementation of Quality Management projects and activities.
• Converts results of data analysis into meaningful business information to disseminate conclusions about the overall function of the department.
• Support quality committees execution and reporting to quality committees.
• Performs quantitative and qualitative data analysis to achieve operational targets.
• Prepares Quality Management documents that adhere to the interpretation and application of business requirements.

Required Qualifications

• Must reside in Florida or be willing to relocate to Florida within 3 to 4 months of the start date. Relocation assistance is not provided.
• Minimum 3 years experience in managed care quality and/or provider quality.
• Experience leading or supporting performance improvement projects (PIPs) and/or NCQA accreditation.
• Must be proficient in all Microsoft office Suite, especially Microsoft Excel and PowerPoint.
• Must be analytical and able to interpret data.
• Must be articulate and able to communicate to multiple internal and external stakeholders.

Preferred Qualifications

• Performance Improvement Projects (PIPs) experience.
• NCQA accreditation experience.

Education

• Bachelor’s degree or equivalent work experience in managed care quality

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.