Manager, Healthcare Quality Project Management

CVS Health•Carapichaima, MI

3d•$60,300 - $132,600•Onsite

About The Position

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: The Manager Health Care, Quality Project Management leads cross-functional activities throughout the health plan to address CAHPs and BH survey responses and ensure effective implementation of these activities to gain positive outcomes. This person will facilitate collaborative partnerships with different departments to meet NCQA standards while monitoring for state requirements as they align with Health Plan goals of maintaining and sustaining accreditation status, as well as looking to advance the Health Plan for other accreditation opportunities. In addition, this person will have knowledge of how population health is integrated throughout the plan and will support program creation. Most importantly, the role will involve a thorough knowledge of how to write and develop a QAPI workplan, QAPI program description and evaluation while working with the QM director in managing expectations from the different areas to fulfill these requirements.

Requirements

5+ years experience in a project management role.
3 years experience working in the Health Care Insurance Industry.
Must have experience and full understanding and of the National Committee for Quality Assurance (NCQA) standards
Must be proficient in all Microsoft office Suite, especially Microsoft Excel.
Must be analytical and able to interpret data
Must be articulate and able to communicate to multiple internal and external stakeholders.
Must have experience in leading an organization through accreditation
Must be a proficient writer an possess an innate ability to communicate effectively written and orally.

Nice To Haves

CPHQ certified or PMP certified

Responsibilities

Accountable for NCQA and state projects and initiatives through direction setting and leadership
Develops readiness assessment schedules, conducts in house audits regularly, and ensures changes to the standards are incorporated
Collaborates with business leads to identify variances and areas for improvements and implements project plans to ensure resolution and compliance to NCQA standards
Schedules and conducts NCQA work group meetings to produce and develop the QAPI work plan, evaluation and programs
Facilitate ongoing annual qualitative and quantitative analyses, assuring business owners are taking action on their opportunities for improvement
Quality Improvement Projects Assists in quality improvement initiatives related to accreditation, including but not, limited to the engineering of operational processes to improve efficiencies and achieve continuous quality improvement
Trains and onboards staff and business leads on NCQA standards, and ongoing to ensure their continuing understanding of requirements
Manages CAHPS and provider satisfaction surveys
Creates and identifies work groups to address and develop action items based on CAHPS, Behavioral Health satisfaction surveys and provider satisfaction results including monitoring of implementation of actionable items within the plan
Coordinates QMOC, QMC and UMC
Oversees maintenance of MHC distinction award and/or other accreditations
Performs regular audits of website, member handbooks, provider manuals and newsletters for NCQA compliance