Quality Management Senior Analyst

CVS Health

Work At Home, WA

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JOB DETAILS

SALARY

$46,988–$122,400 Per Year

SKILLS

Analysis Skills, Benchmarking, Communication Skills, Data Analysis, Data Management, Data Modeling, Establish Priorities, Federal Laws and Regulations, Geography, Health Information Technology, Health Maintenance, Healthcare, Healthcare Effectiveness Data and Information Set (HEDIS), Healthcare Quality, Incentive Programs, Industry/Trade Analysis, Information Technology & Information Systems, Leadership, Maintain Compliance, Managed Care, Medicaid, Medicare, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, National Committee for Quality Assurance (NCQA), Performance Management, Performance Metrics, Performance Tuning/Optimization, Power BI, Process Improvement, Program Evaluation, Qualitative Analysis, Quality Assurance, Quality Management, Quality Metrics, Quantitative Analysis, Regulatory Reports, Regulatory Requirements, Reporting Dashboards, Return on Investment (ROI), SQL (Structured Query Language), Safety/Work Safety, Service Delivery, State Laws and Regulations, Statistics, Systems Analysis, Tableau

LOCATION

Work At Home, WA

POSTED

3 days ago

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. **Position Summary** Leverages technology and data to improve healthcare outcomes by designing, implementing, and maintaining health information systems, analyzing quality healthcare data, and applying statistical analysis to create effectiveness analyses and other health outcomes analyses. Applies expertise in healthcare and information technology to ensure efficient data management, promote data-driven insights, and enhance the delivery of healthcare services. Provides support in completing regulatory reporting requirements and contributes to the development and execution of HEDIS strategy to ensure compliance and optimize performance in quality measurement initiatives. Responsibilities include: + Leads the management of quality data, regulatory reporting, and analytics functions to enable internal teams to draw meaningful, actionable conclusions. + Conducts literature reviews, as appropriate, to assess the current state of quality initiatives and ensure alignment with industry trends and benchmarks. + Designs and develops dashboards and reporting solutions (e.g., Power BI, Tableau) to effectively communicate insights to a range of audiences, from operational teams to executive leadership. + Defines and implements data models, statistical methodologies, and reporting frameworks to ensure accurate, reliable, and scalable data analysis. + Translates analytical findings into clear business insights, informing decision-making and driving performance improvement across the Quality function. + Performs quantitative and qualitative analyses to support achievement of NCQA HEDIS, Medicare Stars, and other quality performance metrics. + Leads analysis of intervention effectiveness, including evaluation of program impact, return on investment, and contribution to measure performance improvement. + Partners with clinical, operations, and quality leadership to inform measure-level strategy, including identification of performance gaps, prioritization of interventions, and ongoing optimization of improvement efforts. + Provides analytical support for regulatory reporting (e.g., PIPs), including statistical analysis of interventions and evaluation of their impact on performance outcomes. **Required Qualifications** + At least 5 years experience in managed care or similar healthcare environment that includes HEDIS + 3+ years of experience with statistical analysis and ability to analyze and interpret data. + 3+ years experience in Microsoft office Suite, especially Microsoft Excel and PowerPoint as well as Tableau, SQL and/or PowerBI or similar dashboarding software + Must be articulate and able to communicate to multiple internal and external stakeholders **Preferred Qualifications** + Medicaid and/or Medicare managed care experience **Education** + Bachelor's degree or equivalent work experience in healthcare data **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $122,400.00 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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland) . We anticipate the application window for this opening will close on: 06/05/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.

About the Company

CVS Health

INDUSTRY

Other/Not Classified

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