Sr. Analyst, Medicare Strategy - Work From Home

Senior Manager Health Care Quality Management

The Senior Manager Health Care Quality Management will be responsible for managing the Quality Program for the Florida Fully Integrated Duals Eligible (FIDE) plan. This involves oversight and execution of contractually required Medicare and Medicaid regulatory deliverables, HEDIS activities, quality improvement activities and internal and external reporting.

Key Responsibilities

• Quality Program / Plan Compliance : Develop the annual quality program (QAPI) trilogy documents (program description, workplan, program evaluation) in compliance with state and federal requirements. Monitor QAPI activities through supporting workplan management. Ensure all Integrated Duals Quality Policies comply with contract requirements. Support internal and external QAPI audits and surveys as needed. Adhere to NCQA standards and work with National Quality Management Accreditation team to maintain the plan's NCQA accreditation as required.
• Cross-Team Collaboration : Work with key stakeholders and key resources across the Integrated Duals and enterprise to develop, drive and deliver on QAPI program activities and initiatives. Coordinate and implement interventions to increase HEDIS, CAHPS, performance improvement projects and designated health measures to meet contract and plan goals.
• Reporting & Communication : Prepare and support the development of reports, presentations, and other documentation to communicate QAPI program outcomes and performance monitoring. This applies to internal and external plan partners. Develop data sets, KPIs, and other types of needed to execute the QAPI program ensure data accuracy and integrity to meet internal and regulatory requirements.
• Performance Evaluation & Recommendations : Assist in evaluating the QAPI program on an ongoing basis and support the QAPI program improvement process.

Required Qualifications

Preferred Qualifications

Education

Bachelor's Degree or equivalent experience

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is :

$46,988.00 - $102,000.00

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.

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 our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include :

Affordable medical plan options, 401(k) plan (including matching company contributions), and employee stock purchase plan.

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.