Health Care Quality Management Specialist – Remote – Must Reside in FL

This is a fully remote position, open to applicants in Florida.

📋 Description

• Develop and implement a quality management strategy that aligns with the expectations of both internal and external stakeholders, ensuring quality outcomes in accordance with NCQA and state regulations for Medicaid and CHIP.

• Connect quality management initiatives to business objectives through innovation, integration, and effective use of information.

• Engage in the creation and continuous execution of Quality Management work plans and activities.

• Facilitate the accreditation process for health plans, health outcomes, and long-term support services.

• Assist in meeting quality contract stipulations, including performance improvement projects, evaluation of quality improvement efforts, and program assessments.

• Contribute to the development and execution of Quality Management initiatives and projects.

• Transform data analysis findings into valuable business insights and share conclusions regarding departmental performance.

• Aid in the execution and documentation of quality committees.

• Conduct both quantitative and qualitative data analyses to meet operational benchmarks.

• Create Quality Management documentation that complies with business standards.

⛳️ Requirements

• Candidates must either live in Florida or be prepared to relocate there within 3 to 4 months of starting the position.

• A minimum of 3 years of experience in managed care quality or provider quality is required.

• Proven experience in leading or assisting with performance improvement projects (PIPs) and/or NCQA accreditation processes.

• Strong proficiency in the Microsoft Office Suite, particularly Microsoft Excel and PowerPoint.

• Excellent analytical skills with the ability to interpret data effectively.

• Strong communication skills for engaging with various internal and external stakeholders.

• A Bachelor’s degree or equivalent work experience in managed care quality is necessary.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program.

• Comprehensive medical coverage.

• Dental coverage options.

• Vision coverage available.

• Paid time off benefits.

• Retirement savings plans.

• Wellness programs to support overall health.

• Additional resources to enhance physical, emotional, and financial well-being.

• Please note that relocation assistance is not available.