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Job Description
Implement an all product quality management strategy that meets internal and external member expectations for demonstrating quality outcomes.
Using innovation, integration, and information links the quality management activities to business goals.
Health Care Quality Management includes, but
is not limited to, QM Programs/Infrastructure, behavioral health QM, credentialing, delegation and regulatory accreditation support, clinical and service measurement and improvement and quality of care investigations.
Required Qualifications
5+ years of implementation of accreditation in all lines of business and managed care.
Ability to work in a fast paced environment.
Ability to plan, organize, and execute multiple functional goals.
Experience managing staff.
COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Preferred Qualifications
Experience in one or more of the following:
Medicaid Accreditation
Disease Management
Case Management
Network Management
Utilization Management
Education
Certified Professional in Health Quality (CPHQ) or other certification a plus
Masters degree preferred.
Bachelor’s degree desired or equivalent work experience
Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
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.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
