[Hiring] Analyst, Health Care Quality Management @CVS Health

Role Description

Implements an all-product quality management strategy that meets internal and external constituent expectations for demonstrating quality outcomes. 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.

• Works to achieve day-to-day objectives for the Health Care Quality Management (QM) function.
• Condenses complex data information into a clear and precise picture while working independently.
• 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.
• Documents QM activities to demonstrate compliance with business, regulatory, and accreditation requirements.
• Makes outbound calls to members to provide assistance in obtaining services (i.e., provide reminders, make appointments, arrange transportation, etc.) to avoid delays in treatment and improve member health outcomes.
• Performs quantitative and qualitative data analysis to achieve operational targets.
• Prepares QM documents that adhere to the interpretation and application of business requirements.
• Reports business information to internal and external constituents and consults on solutions for emergent issues.

Qualifications

• Prior experience in the healthcare industry.
• Prior clinical and/or managed care experience in the healthcare industry or quality management.
• 1-2 years work experience.
• Experience developing presentations and working with data.

Requirements

• Extensive Microsoft Excel experience.
• HEDIS knowledge.
• Bachelor's degree preferred; HS Diploma/G.E.D required.

Benefits

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs.
• Other resources, based on eligibility.