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　　Position SummaryAccountable for Medicare NCQA Accreditation quality projects and initiatives through design, development and implementation. Supporting Medicare growth initiatives to drive improvement for Stars and Health Plan Ratings. Manage special projects such as the Institute for Healthcare Improvement (IHI) Medicare Advantage Plan Engagement demonstration project and health equity initiatives.

　　Defines the requirements per the contract, to ensure meets all NCQA analysis criteria for Accreditation

　　Accountable for business decisions based on the results of research and data analysis.

　　Collaborates and presents to Network, clinical, provider relations, Community Development/Pop Health

　　Responsibility for decision making regarding the design, development, and implementation strategy of quality improvement projects, and initiatives.

　　May manage a QM functional department including development and oversight of performance metrics and application of HR policies and procedures.

　　Forms and leads cross functional teams to assist business units in integrating quality into their strategic and operational plans.

　　E valuates and prioritizes recommendations for quality improvement to senior management and/or customers.

　　Partners with sales and marketing across all segments in their efforts to acquire and retain customers (e.g. responding to RFPs), quality presentations, request for measurement information.

　　Develops and implements the infrastructure of the QM program and Patient Safety strategy. Develops, implements, and evaluates the organization’s policies and procedures to meet business needs.

　　Directs/provides enhancements to business processes, policies and infrastructure to improve operational efficiency across the organization.

　　Influences department business owners and leaders to reach solutions to meet the needs of Plan Sponsors, regulators and other customers while meeting departmental objectives.

　　Performs strategic analysis of business performance data to address Plan Sponsor needs.

　　In partnership with business owners, supports design /development of new or enhanced products and services.

　　Translates knowledge of subject and business needs into clear strategic business plans.

　　Serves as a technical, professional and/or business expert that may cross multiple business functions

　　Required Qualifications

　　6+years progressive experience in operational quality management roles in the healthcare industry, regulatory environment, NCQA accreditation and/or quality management. Preferred Qualifications

　　Certified Professional in Health Quality (CPHQ) or other certification a plus. Education Bachelor's degree, Nursing degree, or other comparable healthcare experience. Master's degree preferred

　　Pay Range

　　The typical pay range for this role is:

　　$75,400.00 - $166,000.00

　　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. This position also includes an award target in the company’s equity award program. 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 jobs.CVSHealth.com/benefits

　　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.

　　CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.