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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position Summary
Designs and 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. Analyzes and reports on findings on health plan activities and performance.
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Responsibilities include:
• 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
• Lead CAHPS improvement activities
• 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
• At least 3 years experience in managed care quality and/or 5 years in Medicaid managed care
• 1-2 years Experience leading or managing performance improvement projects and/or Direct Quality NCQA accreditation
- 1-2 years PIP Experience
• Must be analytical and able to interpret data
• Must be proficient in all Microsoft office Suite, especially Microsoft Excel and PowerPoint
• Must be articulate and able to communicate to multiple internal and external stakeholders
• Bachelor's degree or equivalent work experience in managed care quality
• Must live in FL
Preferred Qualifications
• Master's degree preferred
• NCQA accreditation experience
• Medicaid managed care experience
Education
(under required qualifications)
Pay Range
The typical pay range for this role is:
$46,988.00 - $91,800.00
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.
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 Health
We anticipate the application window for this opening will close on: 10/11/2024
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.