CVS Health
Senior Quality Manager - Exchange
CVS Health, Los Angeles, California, United States, 90079
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 SummaryThe Quality Management organization is responsible for leading the delivery of Aetna quality and compliance efforts, cross-functional reporting, and cultural transformation. This position will be managing Covered CA quality requirements across quality programs, leading the Enrollee Experience Survey (EES) Strategy for the Exchange membership, and providing outreaches/education in focus Exchange markets to support improved health outcomes.Lead provider education/outreach opportunities in focus Exchange markets to improve targeted population health quality and outcomes. These education sessions will engage and educate providers in understanding EES, HEDIS, improving measure results, closing gaps in care, and more.Support business growth and positive external business relationships for Covered CA through contract reviews, state proposal requests, presentations, and meetings.Ensure specific QIS requirements for Covered California are implemented, monitored, and reported to Covered CA including but not limited to improving Hospital Safety, Maternity Care, and Quality Transformation Initiatives (QTIs).Manage disparity reduction plans for Covered California that includes baseline disparity identification, root cause analysis, interventions, and strategies along with implementation timeline, evaluation, and proposed improvement target.Partner on annual Covered CA updates to the Health Equity Program Description and Evaluation assessing the effectiveness of the Health Equity (HE)/Culturally and linguistically appropriate services (CLAS) program activities.Lead the design and implementation of our EES strategy, ensuring we have actions to maximize results in our focus areas and improve survey participation.Required Qualifications- 7+ years of clinical quality work experience- 3+ years’ experience working with Regulatory Agencies, including CA- 5 years background in healthcare strategy and planning experience- 5+ years provider or member outreach experience- 1 year+ Project Management experienced- 3 years’ experience leading strategic initiatives- Strong communication skills- Critical thinking skillsPreferred Qualifications- Registered Nurse- 2 years experience working with Medicaid or Exchange Contract RequirementsEducationBachelor's Degree or equivalent experiencePay RangeThe typical pay range for this role is: $75,400.00 - $199,144.80This 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.For more detailed information on available benefits, please visit
Benefits | CVS HealthWe anticipate the application window for this opening will close on: 09/28/2024Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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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 SummaryThe Quality Management organization is responsible for leading the delivery of Aetna quality and compliance efforts, cross-functional reporting, and cultural transformation. This position will be managing Covered CA quality requirements across quality programs, leading the Enrollee Experience Survey (EES) Strategy for the Exchange membership, and providing outreaches/education in focus Exchange markets to support improved health outcomes.Lead provider education/outreach opportunities in focus Exchange markets to improve targeted population health quality and outcomes. These education sessions will engage and educate providers in understanding EES, HEDIS, improving measure results, closing gaps in care, and more.Support business growth and positive external business relationships for Covered CA through contract reviews, state proposal requests, presentations, and meetings.Ensure specific QIS requirements for Covered California are implemented, monitored, and reported to Covered CA including but not limited to improving Hospital Safety, Maternity Care, and Quality Transformation Initiatives (QTIs).Manage disparity reduction plans for Covered California that includes baseline disparity identification, root cause analysis, interventions, and strategies along with implementation timeline, evaluation, and proposed improvement target.Partner on annual Covered CA updates to the Health Equity Program Description and Evaluation assessing the effectiveness of the Health Equity (HE)/Culturally and linguistically appropriate services (CLAS) program activities.Lead the design and implementation of our EES strategy, ensuring we have actions to maximize results in our focus areas and improve survey participation.Required Qualifications- 7+ years of clinical quality work experience- 3+ years’ experience working with Regulatory Agencies, including CA- 5 years background in healthcare strategy and planning experience- 5+ years provider or member outreach experience- 1 year+ Project Management experienced- 3 years’ experience leading strategic initiatives- Strong communication skills- Critical thinking skillsPreferred Qualifications- Registered Nurse- 2 years experience working with Medicaid or Exchange Contract RequirementsEducationBachelor's Degree or equivalent experiencePay RangeThe typical pay range for this role is: $75,400.00 - $199,144.80This 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.For more detailed information on available benefits, please visit
Benefits | CVS HealthWe anticipate the application window for this opening will close on: 09/28/2024Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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