, New Hampshire

Job Description
Lead technical role on Medicaid Quality Data Management team, providing guidance and leadership to advanced analysts and partnering with Aetna Information Technology teams to successfully implement NCQA HEDIS & Medicaid State-specific measure technical specifications in Aetna proprietary Quality/HEDIS measures rules engine.

Pay Range
The typical pay range for this role is:
Minimum: 95,000
Maximum: 209,000

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications
- 5+ years of experience with healthcare claims analysis.
- 5+ years of experience; skilled in reading and writing moderate to complex SQL commands and accurately assessing results.
- Experience with analyzing HEDIS metrics or Functional SME for HEDIS reporting.

COVID Requirements

COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications
- Experience with HEDIS vendor software a plus or experience with HEDIS reporting using other tools.
- Experience gathering requirements from the client/business and documenting.
- Experience with process improvement, workflow, benchmarking and / or evaluation of business processes.
- Project Management experience a plus.
- Coach, provide feedback, and guide others act as a resource for others with less experience.
- Technical skill is required as this position is a mix of business and technical skills.
- Working knowledge of relational databases, database structures.
- Ability to write clearly composed documentation for business requirements documentation as well as information that will be distributed to auditors.
- Ability to problem solve including multiple priorities and research conflicting and/or inaccurate data.

Bachelor's degree and/or equivalent experience in keeping with strict required qualifications.

Business Overview
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.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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. See Job Description

, New Hampshire

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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