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.
Position Summary
This position supports key initiatives within HEDIS Outcomes by leading vendor-supported operations, medical record abstraction processes, cross-functional projects, and quality-focused implementations tied to HEDIS measures and technical specifications. This role is responsible for coordinating operational workflows, supporting data integrity, overseeing medical record uploads, managing vendor and repository relationships, and partnering across markets and business teams to drive successful execution.
The ideal candidate brings strong HEDIS measure experience and knowledge, as well as vendor experience, along with the ability to manage complex operational processes, collaborate across internal and external stakeholders, and support project execution in a fast-paced, highly regulated environment.
Key Responsibilities
- Manage third-party vendor operations, monitoring compliance with all aspects of the SOW, supporting medical record abstraction, quality review, and special projects aligned with the NCQA Technical Specifications
- Oversee calibration of offshore and onshore record review practices, including collaboration on HEDIS measure training, testing, abstraction, and documentation
- Establish and maintain vendor processes for medical record intake, internal workflow alignment, and reporting of results to providers
- Support compliance and privacy-related coordination and negotiations tied to vendor processes, record access, and operational workflows
- Develop, update, and maintain documentation, training guides, and standard operating procedures for internal teams and business partners
- Monitor compliance with all aspects of the vendor SOW, intake and abstraction analytics, and regular reporting and leadership updates
- Partner with the Vendor Management Organization to support and review Statements of Work, Requests for Proposal, staffing models, accounting considerations, and long-range workload forecasting aligned with HEDIS business needs
- Coordinate staffing-related activities tied to offshore operations, including onboarding review, background check processes, Workday profile setup and updates, and staff transfers
- Partner closely with Quality Management teams, Stars market partners, Engagement Managers, RN/PM specialists, and other business stakeholders to support audit readiness, research requests, special project management, and successful outcomes across abstraction operations
Required Qualifications
- 3 + years strong HEDIS measure experience and working knowledge of HEDIS technical specifications
- 3 + years’ experience managing HEDIS-related operations, medical record abstraction, quality review, or related healthcare quality initiatives
- 2 + year’s vendor management experience or equivalent
- Demonstrated ability to analyze information, support reporting, and monitor data integrity
- Strong organizational skills with the ability to manage multiple priorities in a fast-paced environment
- Experience working across internal and external stakeholders to support operational execution and process improvement
- Strong written and verbal communication skills
- Proficiency in Microsoft Office applications, including Excel, PowerPoint, and Word
- Ability to work EST due to areas covered
Preferred Qualifications
- Project management experience in a vendor, healthcare, quality, or operational environment
- Experience leading cross-functional projects involving vendors, data processes, and operational implementation
- Experience working with medical record exchange technologies, repository vendors, or regulated data workflows
- PMP certification or formal project management training preferred
Education
- Bachelor’s Degree or Equivalent
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$60,300.00 - $132,600.00This 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.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Skills Required
- 3+ years of strong HEDIS measure experience and working knowledge of HEDIS technical specifications
- 3+ years of experience managing HEDIS-related operations, medical record abstraction, quality review, or related healthcare quality initiatives
- 2+ years of vendor management experience or equivalent
- Ability to analyze information, support reporting, and monitor data integrity
- Strong organizational skills and ability to manage multiple priorities in a fast-paced environment
- Experience working across internal and external stakeholders to support operational execution and process improvement
- Strong written and verbal communication skills
- Proficiency in Microsoft Office applications, including Excel, PowerPoint, and Word
- Ability to work Eastern Standard Time hours
- Bachelor's degree or equivalent
- Project management experience in a vendor, healthcare, quality, or operational environment
- Experience leading cross-functional projects involving vendors, data processes, and operational implementation
- Experience with medical record exchange technologies, repository vendors, or regulated data workflows
- PMP certification or formal project management training
CVS Health Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about CVS Health and has not been reviewed or approved by CVS Health.
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Healthcare Strength — Health coverage includes medical, dental, and vision with HSA-eligible options, free preventive care, virtual care, and access to MinuteClinic services. Mental-health resources such as counseling support are emphasized, and coverage is often considered solid for full-time colleagues.
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Retirement Support — A dollar-for-dollar 401(k) match up to 5% after one year and an Employee Stock Purchase Plan are consistently highlighted in Total Rewards materials. Feedback suggests retirement programs are a meaningful strength within the overall package.
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Wellbeing & Lifestyle Benefits — Wellbeing offerings include up to 20 no-cost counseling sessions per issue, backup care, tuition assistance, and substantial in-store discounts, alongside broader wellness tools. These everyday perks expand value beyond base pay and can be especially meaningful for full-time schedules.
CVS Health Insights
What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
