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Position Summary

This position will be working from home anywhere in the continental US.

Manages and influences health care quality projects and initiatives through design, development, and implementation. These activities enable Aetna to improve health care quality products, services, and processes by partnering across business units to meet business needs and accomplish goals. In the Health Care Quality Project Manager position, you will work on auditing and preparing standards of compliance for NCQA accreditation. You will prepare analyses with NCQA guidelines to help ensure all accreditation requirements are met. You will be accountable for health care quality projects and initiatives through direction setting and leadership. You will proactively develop quality activities aligned with company strategies and values. You will link the quality management activities to business goals. This position requires that you proactively build strong teams and business relationships, both internally and externally. You will serve as a resource and subject matter expert (SME) on aspects of the quality program to develop and influence business strategies.
Prioritizes and makes recommendations for the design, development, and implementation strategy of quality improvement projects, and initiatives. Makes business decisions based on the results of research and data analysis. Has responsibility for decision making regarding the design, development, and implementation strategy of quality improvement projects, and initiatives. Forms and leads cross functional teams to assist business units in integrating quality into their strategic and operational plans. Develops, implements, and evaluates the organization’s policies and procedures to meet business needs. Translates and delivers business information to internal and external constituents via formal presentations and/or written communications. Develops documentation templates and systems to support QM projects and initiatives. Educates and consults with unit business managers on quality improvement methods (e.g., work flow, data analysis, metrics).

Required Qualifications

-3+ years NCQA Accreditation experience

-3+ years managed care experience in the healthcare industry and quality management required
-Good business acumen
-MS Office Programs: Excel, Word, Power Point, and Outlook

Preferred Qualifications

-Master’s degree or equivalent experience

-One of the following: Social Work License, RN License, LPN License acceptable

-Statistical analysis experience

-Familiarity with CAHPS Survey

-Familiarity with Medicare Health Outcomes Survey

-Experience in measuring member and practitioner satisfaction

Education-Bachelor’s degree or equivalent experience

Pay Range

The typical pay range for this role is:

$66,330.00 - $145,860.00

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. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 01/31/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.