Analyst, Health Care Quality Management - Remote

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.

• →Evaluate process compliance and operational workflows for delegated credentialing functions.
• →Evaluate adherence to NCQA standards, applicable federal and state regulations, and contractual requirements.
• →Review and validate the accuracy, completeness, and timeliness of delegate-submitted reports, logs, and supporting materials.
• →Ensures compliance and maintains readiness for NCQA accreditation.
• →Corrective actions plans and tracking.
• →Works to achieve day-to-day objectives for the Health Care Quality Management (QM) function.
• →Assists in the development and implementation of QM projects and activities.
• →Documents QM activities to demonstrate compliance with business, regulatory, and accreditation requirements.
• →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.

Preferred Qualifications:

• →Minimum of 2 years of delegated credentialing experience within 2–5 years of overall credentialing experience.
• →Self-motivated team player who effectively manages multiple priorities and adapts to changing demands.
• →Demonstrates strong attention to detail, organizational abilities, and excellent documentation skills.

Required Qualifications :

• →3+ years work related experience in the healthcare industry or quality management.
• →Strong computer skills including mastery of MS Excel, Word and Adobe Acrobat
• →Strong communication skills with external clients, primarily delegate entity contacts.

The typical pay range for this role is:

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. 
 

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.