Senior Quality Manager

2 weeks ago


Santa Ana, California, United States CVS Health Full time
Job Summary

CVS Health is seeking a highly skilled Senior Quality Manager to lead our quality management organization in delivering exceptional quality and compliance efforts. As a key member of our team, you will be responsible for driving cross-functional reporting and cultural transformation.

Key Responsibilities
  • Manage Covered CA quality requirements across quality programs, ensuring compliance and excellence.
  • Develop and implement the Enrollee Experience Survey (EES) strategy to improve survey participation and results.
  • Lead provider education and outreach opportunities in focus Exchange markets to enhance targeted population health quality and outcomes.
  • Support business growth and positive external business relationships through contract reviews, state proposal requests, and presentations.
  • Ensure specific QIS requirements for Covered California are implemented, monitored, and reported to Covered CA.
  • Develop and implement disparity reduction plans for Covered California, including baseline disparity identification, root cause analysis, interventions, and strategies.
  • Partner on annual Covered CA updates to the Health Equity Program Description and Evaluation, assessing the effectiveness of the Health Equity (HE)/Culturally and Linguistically Appropriate Services (CLAS) program activities.
Requirements
  • 7+ years of clinical quality work experience.
  • 3+ years of experience working with Regulatory Agencies, including CA.
  • 5 years of background in healthcare strategy and planning experience.
  • 5+ years of provider or member outreach experience.
  • 1 year+ of Project Management experience.
  • 3 years of experience leading strategic initiatives.
  • Strong communication and critical thinking skills.
Preferred Qualifications
  • Registered Nurse.
  • 2 years of experience working with Medicaid or Exchange Contract Requirements.
What We Offer

CVS Health offers a comprehensive benefits package, including medical, dental, and vision benefits, 401(k) retirement savings plan, and an Employee Stock Purchase Plan. We also provide a fully-paid term life insurance plan, short-term and long-term disability benefits, and numerous well-being programs.

As a CVS Health employee, you will enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. We are an equal opportunity and affirmative action employer, committed to diversity and inclusion.



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