Manager, Clinical Quality

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 Clinical Quality Manager supports the Duals (MMP and FIDE) HEDIS team through data collection and abstraction of medical records for HEDIS projects, HEDIS like projects, year-round medical record collection and regulatory state audits. The Clinical Quality Manager will serve as a HEDIS measure subject matter expert while also providing mentorship/guidance to HEDIS Coordinator staff.Participates in the coordination and preparation of the HEDIS medical record review project which includes ongoing review of records submitted by providers and year-round HEDIS medical record review.Participates in team meetings to strategize and prioritize medical record collection.Collaborate with providers to acquire EMR access and opportunities for additional supplemental data.Support the onboarding and training of annual HEDIS Coordinator staff for hybrid medical record review project.Responsible for tasks assigned by the Sr. Manager during the HEDIS hybrid project.Utilize various data collection tools for medical record entry and uploading.Support in the development and/or implementation of activities to improve HEDIS and Star ratings.Work with the National Quality team to support member and provider initiatives.Lead meetings when needed for subject matter expertise such as measure training and sharing of best practices.Assists with projects as needed.Perform all other duties as assigned.Required QualificationsMinimum three years experience in HEDIS.Strong knowledge of Medicare Stars measures.Strong problem solving skills.Ability to manage multiple tasks as assigned.Ability to work extended hours as needed during annual HEDIS hybrid project.Preferred Qualifications3 years of project management experience.EducationBachelor’s degree in health-related field or 3-5 years of experience.Pay RangeThe typical pay range for this role is:$54,300.00 - $119,340.00This 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.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: 12/31/2024Qualified 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.