[Hiring] Senior Quality Consultant @CVS Health

Role Description

Quality check complex benefit information, including non-standard plan language into crisp, compliant, easy-to-understand plan language for self-funded plans. This includes:

• Analyzing, drafting, editing, and reviewing all legal and regulatory plan documentation (i.e., SPDs, plan amendments, SBCs, and restates) for our self-funded plan customers.
• Basic understanding of regulations, laws, and internal procedures impacting self-funded health plans with attention to ensuring compliance with federal and state law.
• Successfully negotiate deadlines when appropriate; influence change/enhancement to business processes, policies, and system infrastructure to improve information quality, availability, and access.
• Deliver high-quality documentation ensuring department standards are met with a focus on correcting all errors in spelling, grammar, and formatting before sending documents to customers.
• May participate in implementation of department projects as needed.
• Other duties as assigned.

Qualifications

• 3-5 years of plan writing experience supporting self-funded or fully insured plans.
• Proficiency with Microsoft Office Word, Excel, SharePoint, and Outlook applications.

Requirements

• Adept at problem solving and decision making skills.
• Quality Improvement Associate Certification (CQIA).
• Interpersonal skills to include written and verbal communication, critical thinking, persuasiveness, advising, and counseling skills.
• Ability to anticipate workload needs and to follow through with minimum direction.
• Effective time management, organizational, and prioritization skills.
• Strong attention to detail and accuracy performing at high levels in a fast-paced and constantly changing work environment.

Benefits

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

Company Description

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.