The Manager Health Care, Quality Project Management leads cross-functional activities throughout the health plan to address CAHPs and BH survey responses and ensure effective implementation of these activities to gain positive outcomes. This person will facilitate collaborative partnerships with different departments to meet NCQA standards while monitoring for state requirements as they align with Health Plan goals of maintaining and sustaining accreditation status, as well as looking to advance the Health Plan for other accreditation opportunities. In addition, this person will have knowledge of how population health is integrated throughout the plan and will support program creation. Most importantly, the role will involve a thorough knowledge of how to write and develop a QAPI workplan, QAPI program description and evaluation while working with the QM director in managing expectations from the different areas to fulfill these requirements.

• Accountable for NCQA and state projects and initiatives through direction setting and leadership
• Develops readiness assessment schedules, conducts in house audits regularly, and ensures changes to the standards are incorporated
• Collaborates with business leads to identify variances and areas for improvements and implements project plans to ensure resolution and compliance to NCQA standards
• Schedules and conducts NCQA work group meetings to produce and develop the QAPI work plan, evaluation and programs
• Facilitate ongoing annual qualitative and quantitative analyses, assuring business owners are taking action on their opportunities for improvement
• Quality Improvement Projects Assists in quality improvement initiatives related to accreditation, including but not, limited to the engineering of operational processes to improve efficiencies and achieve continuous quality improvement
• Trains and onboards staff and business leads on NCQA standards, and ongoing to ensure their continuing understanding of requirements
• Manages CAHPS and provider satisfaction surveys
• Creates and identifies work groups to address and develop action items based on CAHPS, Behavioral Health satisfaction surveys and provider satisfaction results including monitoring of implementation of actionable items within the plan
• Coordinates QMOC, QMC and UMC
• Oversees maintenance of MHC distinction award and/or other accreditations
• Performs regular audits of website, member handbooks, provider manuals and newsletters for NCQA complianceRequired Qualifications
• 3 years experience in a project management role.
• 3 years experience working in the Health Care Insurance Industry.
• Must have full understanding of NCQA standards
• Must be proficient in all Microsoft office Suite, especially Microsoft Excel.
• Must be analytical and able to interpret data
• Must be articulate and able to communicate to multiple internal and external stakeholders.
• Must have experience in leading an organization through accreditation
• Must be a proficient writer an possess an innate ability to communicate effectively written and orally.

Preferred Qualifications
CPHQ certified or PMP certified

Education
Bachelors Degree or equivalent work experience.Pay Range

The typical pay range for this role is:$60,300.00 - $132,600.00This 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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS HealthWe anticipate the application window for this opening will close on: 01/31/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.