Senior Quality Consultant

CVS Health

1d • $19 - $42

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 Quality check complex benefit information, including non-standard plan language into crisp, compliant, easy-to-understand plan language for self-funded plans. This includes analyzing, drafting, editing, and reviewing all legal and regulatory plan documentation (i.e., SPDs, plan amendments. SBCs and restates) for our self-funded plan customers. Basic understanding of regulations, laws, and internal procedures impacting self-funded health plans with attention to ensuring the plan and company remain in compliance with federal and state law. Successfully negotiate deadlines when appropriate; influences change/enhancement to business processes, policies, and system infrastructure to improve information quality, availability, and access. Deliver high-quality documentation ensuring department standards are met with a focus on ensuring all errors in spelling, grammar, and formatting are corrected before the document is sent to the customer. May participate in implementation of department projects as needed. Other duties as assigned.

Requirements

• 3-5 years of plan writing experience supporting self-funded or fully insured plans.
• Proficiency with Microsoft Office Word, Excel, SharePoint and Outlook applications.

Nice To Haves

• Adept at problem solving and decision making skills.
• Quality Improvement Associate Certification (CQIA).
• Interpersonal skills to include written and verbal communication, critical thinking, persuasiveness, advising and counseling skills.
• Ability to anticipate workload needs and to follow through with minimum direction.
• Effective time management, organizational and prioritization skills.
• Strong attention to detail and accuracy performing at high levels in a fast paced and constantly changing work environment.

Responsibilities

• Quality check complex benefit information, including non-standard plan language into crisp, compliant, easy-to-understand plan language for self-funded plans.
• Analyzing, drafting, editing, and reviewing all legal and regulatory plan documentation (i.e., SPDs, plan amendments. SBCs and restates) for our self-funded plan customers.
• Basic understanding of regulations, laws, and internal procedures impacting self-funded health plans with attention to ensuring the plan and company remain in compliance with federal and state law.
• Successfully negotiate deadlines when appropriate; influences change/enhancement to business processes, policies, and system infrastructure to improve information quality, availability, and access.
• Deliver high-quality documentation ensuring department standards are met with a focus on ensuring all errors in spelling, grammar, and formatting are corrected before the document is sent to the customer.
• May participate in implementation of department projects as needed.
• Other duties as assigned.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees