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Quality Management Strategy Designer

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Designs and implements a quality management strategy that meets internal and external constituent expectations for demonstrating quality outcomes, including National Committee for Quality Assurance (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. Analyzes and reports on findings on health plan activities and performance.

Additional responsibilities include but not limited to the following :

• Support accreditation minimally for health plan, health equity, and long term supports and services
• Support quality contract requirements, including performance improvement projects (PIPs), analysis of quality improvement activities, and quality program evaluation
• Measure adherence to clinical and preventive health guidelines
• Assists in the development and implementation of QM 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 QM documents that adhere to the interpretation and application of business requirements

Required Qualifications

Preferred Qualifications

Education

Bachelor's Degree or equivalent work experience in managed care quality

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is :

$46,988.00 - $91,800.00

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 our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include :

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.