CVS Health logo
CVS Health

Bringing our heart to every moment of your health.

Senior Analyst, Health Care Quality Management

AnalystAnalystFull TimeRemoteSeniorTeam 10,001+Since 1963H1B No SponsorCompany SiteLinkedIn

Location

California

Posted

2 days ago

Salary

$47.0K - $112.2K / year

Seniority

Senior

Bachelor Degree3 yrs expEnglish

Job Description

• Conduct oversight of external entities contracted to perform clinical functions • Monitor and track delegated entities compliance with regulatory and NCQA requirements • Communicate to delegated entities about industry standards, Aetna policies, and best practices • Prepare delegation oversight evidence for NCQA and regulatory reviews • Participate in industry collaboratives • Support NCQA, CMS, and other regulatory compliance initiatives

Job Requirements

  • One of the following clinical licenses is required: LPN, LVN, or RN
  • Must reside in California
  • 3+ years of Utilization Management and/or Case Management experience
  • 2+ years Delegation Auditing/Oversight experience preferred
  • Strong communication skills with external clients, primarily regulatory and accreditation partners
  • Bachelors degree preferred
  • CA clinical licensure required

Benefits

  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost wellness screenings
  • Tobacco cessation programs
  • Weight management programs
  • Confidential counseling
  • Financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

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