Health Care Quality Management Analyst (Maricopa County, AZ)

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

** Applicants must reside in Maricopa County, AZ.

• Participates in the development and ongoing implementation of QM Work Plan activities. Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet QM objectives.
• Completes a variety of onsite medical and clinical audits for all lines of business including AHCCCS, DES and DCS-CHP
• Conducts exit interviews with clinical and leadership staff to review audit results
• Assists with developing corrective action plans
• Develops audit tools for all populations
• Track completion of corrective action plans
• Completes data entry on all audit tools
• Participates in completing inter rater reliability and scoring guidelines.•
• Participates in QM meetings

Required Qualifications

• At least 1 year of healthcare or behavioral health experience.
• Must be able to travel to providers offices up to 80%
• Knowledge of Microsoft Office Suite with high proficiency of Excel

Preferred Qualifications

• RN or LPN
• Experience in a provider setting
• Medical Record QM Auditing Experience and/or Case Management Experience
• High attention to detail

Education

• High School Diploma or GED

Pay Range

The typical pay range for this role is:

$43,888.00 - $76,500.00

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.

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

We anticipate the application window for this opening will close on: 11/22/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.