Senior Analyst, Health Care Quality Management

CVS Health•Washington, DC

1d•$46,988 - $91,800•Remote

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.

Requirements

Prior experience in the healthcare industry
Prior clinical and/or managed care experience in the healthcare industry or quality management
1-2 years relevant work experience
Experience developing presentations and working with data
HS Diploma/G.E.D minimum

Nice To Haves

Extensive Microsoft Excel experience
HEDIS knowledge
Certified Health Data Analyst (CHDA)
Bachelors preferred

Responsibilities

Provide consultation based on analysis and identification of key drivers of results i.e., use data to identify clinical trends, analyze high-cost claimants, population health and other clinical trends, evaluate performance results, monitor engagement, and collaborate on opportunities for improvement.
Establish and maintain engagement with large provider groups.
Conduct comprehensive analysis of provider performance metrics as well as clinical operations for VBC readiness and risk assessment. This includes clinical quality indicators, patient and provider satisfaction ratings and operational efficiency measures.
Identify areas of improvement and develop data-driven strategies to improve provider performance and financial rewards.
Collaborate with cross-functional teams to assess practice operations against industry best practices in primary care.
Design and deliver training programs, workshops, and educational materials for primary care and specialty providers and their staff in key operational domains to achieve improved health outcomes.
Facilitate sessions on clinic operations, quality standards, regulatory compliance, member experience and patient-centered care to enhance provider skills and knowledge.
Lead initiatives aimed at improving provider performance.
Develop and implement performance improvement plans, monitor progress, and evaluate the effectiveness of interventions in collaboration with practice partners.
Conduct regular audits, reviews, and assessments of provider practices, documentation, and compliance.
Provide feedback and recommendations for improvement.
Collaborate closely with internal teams, including clinical and operational leadership, value-based care, quality management teams and provider relations teams to align provider performance objectives with organizational goals.
Foster effective working relationships with providers, offering guidance, feedback, and support to facilitate their success.
Utilize data management systems and analytics tools to collect, analyze, and report provider performance data.
Prepare comprehensive reports, dashboards, and presentations for senior leadership, highlighting key performance indicators, trends, and improvement opportunities.
Stay abreast of industry trends, best practices, and regulatory changes related to provider performance and healthcare quality.
Support population health and health equity initiatives to improve care gap closure rates and health outcomes.
Conduct research and benchmarking activities to identify innovative approaches and opportunities for improvement.