CVS Health
Sr Mgr, HEDIS Measures Team
CVS Health, Woonsocket, Rhode Island, us, 02895
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.
Position Summary
The Healthcare Effectiveness Data and Information Set (HEDIS) is one of the most widely used healthcare quality data sets in the country. HEDIS calculates how health care organizations perform on various quality metrics across several quality-of-care domains. HEDIS reporting is a requirement for NCQA Accreditation, CMS for Medicare and Exchange lines of business, and various State Medicaid offices, Departments of Insurance and/or Health. HEDIS is tied to performance metrics and performance dollars across the healthcare industry. This position is located on the Clinical Platforms HEDIS Data Enablement and Annual Reporting Team and is responsible for supervision of the HEDIS Measures Team and oversight of the day-to-day HEDIS reporting activities.
Perform research and analysis of HEDIS aggregate- and member-level data in a relational database environment, including writing queries to identify trends, draw conclusions, make recommendations and validate results.
Analyze data and information and summarize findings for internal business customers, auditors, and regulatory agencies
Define and deliver analytical solutions in support of HEDIS reporting.
Identify and address workflow processes and dependencies on an on-going basis to meet all deliverable deadlines.
Collaborate with internal and external partners and organizations to provide subject matter expertise and analytics that answer business questions.
Manage team performance through regular, timely feedback as well as the formal performance review process to ensure high-quality deliverables and ongoing colleague/team development.
Required Qualifications
5+ years experience with health care claims or pharmacy data
5+ years data analytics/validation experience
Ability to quickly grasp business concepts, objectives, and strategies and summarize them
Experience managing multiple projects simultaneously, reassessing priorities and meeting deadlines
Preferred Qualifications
Experience in supervisory role
Familiarly with HEDIS or other quality measurement system
Regulatory reporting and/or audit experience
Experience with SAFe Agile methodology
Education
Bachelor’s Degree or relevant experience in Public Health, Health Care Informatics, Data Science, or related field of study.
Advanced degree preferred.
Pay Range
The typical pay range for this role is:
$75,400.00 - $182,549.40
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. This position also includes an award target in the company’s equity award program.
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 (https://jobs.cvshealth.com/us/en/benefits)
We anticipate the application window for this opening will close on: 11/30/2024
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. 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.
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.
Position Summary
The Healthcare Effectiveness Data and Information Set (HEDIS) is one of the most widely used healthcare quality data sets in the country. HEDIS calculates how health care organizations perform on various quality metrics across several quality-of-care domains. HEDIS reporting is a requirement for NCQA Accreditation, CMS for Medicare and Exchange lines of business, and various State Medicaid offices, Departments of Insurance and/or Health. HEDIS is tied to performance metrics and performance dollars across the healthcare industry. This position is located on the Clinical Platforms HEDIS Data Enablement and Annual Reporting Team and is responsible for supervision of the HEDIS Measures Team and oversight of the day-to-day HEDIS reporting activities.
Perform research and analysis of HEDIS aggregate- and member-level data in a relational database environment, including writing queries to identify trends, draw conclusions, make recommendations and validate results.
Analyze data and information and summarize findings for internal business customers, auditors, and regulatory agencies
Define and deliver analytical solutions in support of HEDIS reporting.
Identify and address workflow processes and dependencies on an on-going basis to meet all deliverable deadlines.
Collaborate with internal and external partners and organizations to provide subject matter expertise and analytics that answer business questions.
Manage team performance through regular, timely feedback as well as the formal performance review process to ensure high-quality deliverables and ongoing colleague/team development.
Required Qualifications
5+ years experience with health care claims or pharmacy data
5+ years data analytics/validation experience
Ability to quickly grasp business concepts, objectives, and strategies and summarize them
Experience managing multiple projects simultaneously, reassessing priorities and meeting deadlines
Preferred Qualifications
Experience in supervisory role
Familiarly with HEDIS or other quality measurement system
Regulatory reporting and/or audit experience
Experience with SAFe Agile methodology
Education
Bachelor’s Degree or relevant experience in Public Health, Health Care Informatics, Data Science, or related field of study.
Advanced degree preferred.
Pay Range
The typical pay range for this role is:
$75,400.00 - $182,549.40
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. This position also includes an award target in the company’s equity award program.
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 (https://jobs.cvshealth.com/us/en/benefits)
We anticipate the application window for this opening will close on: 11/30/2024
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. 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.