Quality – Practice Transformation Advisor

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

📋 Description

• Build and sustain relationships with large provider groups that have a membership of 1,000 or more.

• Evaluate provider performance metrics and clinical operations to assess readiness for value-based care and risk management.

• Identify areas for improvement and create data-driven strategies to enhance provider performance and financial incentives.

• Work collaboratively with cross-functional teams to evaluate practice operations in relation to primary care best practices.

• Develop and deliver training programs, workshops, and educational resources for both providers and staff.

• Lead discussions on clinic operations, quality benchmarks, regulatory compliance, member experience, and patient-centered care.

• Spearhead initiatives for provider performance improvement and execute performance enhancement plans.

• Track progress and assess the effectiveness of interventions in partnership with practice teams.

• Conduct audits, reviews, and evaluations of provider practices, documentation, and compliance standards.

• Collaborate with clinical and operational leadership, value-based care teams, quality management, and provider relations departments.

• Utilize data management systems and analytical tools to gather, analyze, and present provider performance data.

• Create reports, dashboards, and presentations for senior leadership stakeholders.

• Keep abreast of industry trends, best practices, and changes in regulations.

• Support initiatives related to population health and health equity while conducting research and benchmarking activities.

⛳️ Requirements

• 5-7 years of experience in healthcare quality improvement, provider relations, or a similar field.

• Comprehensive knowledge of healthcare regulations, clinical operations, quality standards, and performance metrics.

• Strong analytical and problem-solving capabilities.

• Exceptional communication, presentation, and interpersonal skills.

• Experience in designing and implementing training programs or educational initiatives.

• Proficient in data management and analysis tools, including Excel and data visualization software.

• Familiarity with electronic health record systems and healthcare IT solutions.

• Detail-oriented and organized, capable of managing multiple projects at once.

• Ability to work independently, show initiative, and achieve results in a dynamic environment.

• Must be a resident of Illinois.

• A secure home network is required.

• Familiarity with Microsoft Office products and VPN is necessary.

• A Bachelor's degree or equivalent work experience in healthcare administration, public health, or a related discipline.

• Preference for Licensed Allied Health Professionals or Licensed Registered Nurses.

• Background in coding or sales is preferred.

• Certification as a Six Sigma Green Belt is preferred.

• CPHQ or equivalent certification is preferred.

• Certification as an NCQA PCMH Content Expert is preferred.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to the base salary range.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources aimed at supporting physical, emotional, and financial well-being.