, Texas

Job Description
Works with internal staff across multiple departments to identify data
sources, processes and activities required to meet regulatory and
accreditation requirements or meet the objectives of the QM program.
Conducts outreach with complex provider partners to share information to
improve health outcomes.

Required Qualifications
Takes a role in the development and implementation of QM projects and
activities. May require assistance in budget development and staff
supervision) Delivers Quality information to internal and external
constituents via written and verbal communication May support training of
new QM staff regarding program description, work plan and evaluation
activities Actively seeks opportunities for process improvement resulting in
efficient and effective work streams Independently map out provider
outreach work plan and execute deliverables Supports more complex
relationships with both internal and external constituents. Consults with
constituents on solutions to business issues including education and
process improvement opportunities. Support complex provider partners
with HEDIS gaps in care, data feed, and remote medical record collection
discussions and education. Work closely with the provider partner to
enhance collaboration between provider and Aetna. Independently conduct
measure research during HEDIS medical record project. Performs oversight
of new abstractors

Preferred Qualifications
5 to 7 years clinical and/or managed care experience in the healthcare
industry or quality management.
3 - 5 years’ experience in healthcare or managed care quality management

Education
Bachelor's degree, Nursing degree, or other comparable healthcare
experience.

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.


We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. See Job Description

, Texas

Continue serving and work with a purpose

As a CVS Health colleague, you'll find career opportunities across the organization and at every stage of your career. More important, your work will have an impactful purpose on someone's life, including your own. Learn more about how you can continue serving on your next mission at CVS Health.

Careers for Veterans and Military Spouses

 

"The military has an ethos that is grounded in purpose-driven service that’s bigger than the individual. The same holds true for us at CVS Health. You can talk to colleagues in any part of our business and they will be able to articulate our company’s purpose. Working here provides an opportunity for service members and military spouses to continue to serve, just in a civvies."

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