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.
Schedule
Monday-Friday 8a-5p EST/CST
Position Summary
Applies specialized clinical and industry knowledge and performance improvement best practices to quality improvement efforts. Analyzes workflow and organizational performance to evaluate effectiveness of interventions and ensure continuous alignment with regulatory and accreditation standards. Supports and drives the implementation, measurement, and evaluation of POSC Council workplans. Supports POSC Council and executive sponsors to advance initiatives aimed to achieve HEDIS and CAHPS goals. Provides insights and recommendations to optimize healthcare practices and achieve highest standards of care and service delivery, in alignment with industry and accreditation best practices.
Primary Job Duties & Responsibilities
Develops and implements quality improvement programs and initiatives to monitor and improve healthcare services and processes. Quantitatively and qualitatively analyzes organizational systems and performance in alignment with regulatory and accreditation standards.
Drives and implements evidence-based performance improvement interventions that address areas for improvement, reduce variations in care, and enhance clinical effectiveness. Establishes, tracks and monitors process and outcome measures. Prepares materials and organizational documents and effectiveness for POSC Forum, POSC Council and POSC workgroup discussions in alignment with relevant project plans.
Manages and coordinates specific workplans for assigned POSC workgroups. Facilitates relevant workgroups and committees as required to ensure stakeholder awareness and participation.
Contributes to enhancing healthcare services, improving patient outcomes, and ensuring adherence to regulatory requirements and industry standards.
Contributes to the development, revision, and implementation of policies, procedures, and guidelines that focus on system performance, network provider and community partner performance, and addressing barriers including health disparity and health related social needs, to improve clinical quality, promote best member and provider experience, and ensure patient safety.
Stays up to date on healthcare innovations, quality studies and evidence-based practices by participating in research efforts, contributing to scholarly publications, and/or facilitating research utilization to improve clinical care and outcomes.
Provides training and education to healthcare professionals, staff, and stakeholders on HEDIS and CAHPS related performance, workflow, and dependencies.
Collaborates with all POSC stakeholders and participants to ensure cross-functional collaboration, education and participation in establishing, measuring and evaluating best practice interventions aimed to achieve Quality performance goals.
Required Qualifications
Essential Qualifications and Functions: The minimum knowledge, skills, and abilities (KSAs) which are absolutely required to successfully perform
5-7 years prior relevant work experience – in clinical, case management, administrative, quality / compliance or HEDIS performance-based roles
In depth knowledge of managed care quality, HEDIS and STARs measures, as well as initiatives aimed to drive performance
Strong interpersonal, critical thinking, and analytic skills
Working knowledge of quantitative / qualitative data analytics, and critical thinking skills.
Working knowledge of clinical and practice requirements essential to meet patient care needs.
Ability to deal tactfully with customers and community.
Ability to manage sensitive information ethically and responsibly.
Ability to consider the relative costs and benefits of potential actions to choose the most appropriate option.
Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients.
Excellent communication/presentation and technical writing skills
Registered Nurse (RN) required. Adept at problem solving and decision-making skills
Adept at collaboration and teamwork
Adept at growth mindset (agility and developing yourself and others) skills
Adept at execution and delivery (planning, delivering, and supporting) skills
Preferred Qualifications
Master’s degree in healthcare related field
Certified Professional in Healthcare Quality (CPHQ) preferred.
Education
BSN required
Master's degree in healthcare related field preferred
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$60,522.00 - $129,615.00This 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
- 5-7 years of relevant experience in clinical, case management, administrative, quality, compliance, or HEDIS performance-based roles
- In-depth knowledge of managed care quality, HEDIS, STARs measures, and performance improvement initiatives
- Strong interpersonal, critical thinking, analytical, problem-solving, and decision-making skills
- Working knowledge of quantitative and qualitative data analytics
- Working knowledge of clinical and practice requirements needed to meet patient care needs
- Ability to communicate tactfully with customers and community members
- Ability to manage sensitive information ethically and responsibly
- Ability to evaluate relative costs and benefits when selecting appropriate actions
- Ability to function in clinical settings with diverse cultural dynamics among staff and patients
- Excellent communication, presentation, and technical writing skills
- Registered Nurse (RN) license or credential
- Ability to collaborate and work effectively as part of a team
- Bachelor of Science in Nursing (BSN) degree
- Master's degree in a healthcare-related field
- Certified Professional in Healthcare Quality (CPHQ) certification
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.
-
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.
-
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.
-
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.
