Senior Manager, Health Care Quality Mgmt.
At CVS Health, were building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nations 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
Preference given to candidates residing in eastern and central time zones.
Responsibilities
This position is responsible for managing all HEDIS-related primary source verification activities to support all lines of business, and provides strong leadership for both FTE and temporary clinical data audit teams. Specific responsibilities include:
Manages all HEDIS primary source verification audit processes
Evaluates, interprets, and summarizes clinical components of HEDIS measures
Evaluates, interprets, and summarizes HEDIS supplemental data audit guidelines
Serves as HEDIS measure and supplemental data subject matter expert for stakeholders
Leads a team of clinical data audit FTE staff, as well as a group of temporary colleagues
Monitors, tracks, and reports progress, ensuring adherence to deadlines
Prepares reports/presentations summarizing progress, findings, and recommendations
Required Qualifications
5+ years clinical experience or direct HEDIS audit experience
Ability to work in challenging situations involving competing interests
Strong interpersonal skills, written and verbal communication skills
Ability to work independently and as a team, manage large workload, multiple deliverables, and projects simultaneously.
Preferred Qualifications
Health plan quality experience
People leader experience
Education
Bachelors degree or equivalent
Pay Range
The Typical Pay Range For This Role Is
$67,900.00 - $149,328.00
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. This position also includes an award target in the companys equity award program.
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.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 04/06/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Apply Now
As the nations 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
Preference given to candidates residing in eastern and central time zones.
Responsibilities
This position is responsible for managing all HEDIS-related primary source verification activities to support all lines of business, and provides strong leadership for both FTE and temporary clinical data audit teams. Specific responsibilities include:
Manages all HEDIS primary source verification audit processes
Evaluates, interprets, and summarizes clinical components of HEDIS measures
Evaluates, interprets, and summarizes HEDIS supplemental data audit guidelines
Serves as HEDIS measure and supplemental data subject matter expert for stakeholders
Leads a team of clinical data audit FTE staff, as well as a group of temporary colleagues
Monitors, tracks, and reports progress, ensuring adherence to deadlines
Prepares reports/presentations summarizing progress, findings, and recommendations
Required Qualifications
5+ years clinical experience or direct HEDIS audit experience
Ability to work in challenging situations involving competing interests
Strong interpersonal skills, written and verbal communication skills
Ability to work independently and as a team, manage large workload, multiple deliverables, and projects simultaneously.
Preferred Qualifications
Health plan quality experience
People leader experience
Education
Bachelors degree or equivalent
Pay Range
The Typical Pay Range For This Role Is
$67,900.00 - $149,328.00
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. This position also includes an award target in the companys equity award program.
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.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 04/06/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Apply Now