Remote (Country) Full-time

CVS Health is hiring a Quality Project Manager (Michigan)

About the Role

Oak Street Health is looking for a Quality Project Manager to join our team in Michigan. In this role, you will support deliverables for the State of Michigan Quality Contract, our QAPI Program, and regulatory standards. You will process and evaluate complex data to develop strategic solutions through project management, proactively developing quality activities aligned with program goals and linking quality management to business objectives.

What You'll Do

  • Work with the Director of Quality to assist in making business decisions based on research and data analysis.
  • Lead cross-functional teams to assist health plan departments in integrating quality into their strategic and operational plans.
  • Evaluate and prioritize recommendations for quality improvement to senior health plan management.
  • Help evaluate the Plan's HEDIS Strategy and make recommendations for improvement in closing gaps in care.
  • Help develop strategy and improve Auto Assignment Algorithm (AAA) band ranking performance.
  • Help develop and improve CAHPS Member Satisfaction Survey scores and outcomes.
  • In partnership with functional areas, work to improve Michigan-specific Apple Consumer Guide scores.
  • Help develop and implement improvement strategy for NCQA Star ratings.
  • Work to help facilitate and improve Quality Withhold metrics, as defined by the State.
  • Work with Dental Plan Vendors to improve Dental Program Strategy and performance outcomes.
  • Develop and implement the infrastructure of the QM program, patient safety strategy, and PQOC analysis.
  • Direct and provide enhancements to business processes, policies, and infrastructure to improve operational efficiency.
  • Influence department business owners and leaders to reach solutions that meet stakeholder needs.
  • Provide comprehensive analysis of state PIPs, barriers, and opportunities and present results to plan management.

What We're Looking For

  • 5+ years of progressive experience in a regulatory environment and/or quality management.
  • At least 5+ years of managed care experience.
  • Bachelor’s degree or equivalent managed care experience.

Nice to Have

  • Project Management skills and proficiency.
  • Proficiency with Microsoft Office Suite and other common office software.
  • PMP Certification.
  • Lean Six Sigma (Green/Black Belt).
  • Experience with Tableau Dashboards and analytics.
  • Medicare / Medicaid experience.
  • Experience with HEDIS Metrics, CAHPS Surveys, NCQA Accreditation, Compliance Audits, and/or MI State Reporting.

Technical Stack

  • Microsoft Office Suite
  • Tableau

Team & Environment

You will report to the Director of Quality. The role involves leading cross-functional teams and influencing department business owners and leaders.

Benefits & Compensation

  • Compensation range: $60,300.00 - $132,600.00
  • Affordable medical plan options.
  • 401(k) plan with matching company contributions.
  • Employee stock purchase plan.
  • No-cost programs including wellness screenings, tobacco cessation, weight management, confidential counseling, and financial coaching.
  • Paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access.

Work Mode

This position is local to Michigan.

Oak Street Health is passionate about transforming health care and caring for people where, when and how they choose. We are committed to fostering a workplace where every colleague feels valued and that they belong.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Required Skills
Microsoft Office SuiteTableauProject ManagementData AnalysisProcess ImprovementHealthcare IndustryStakeholder ManagementReportingQuality ManagementCommunication
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About company
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CVS Health is the nation’s leading health solutions company, reaching millions of Americans through local presence, digital channels and more than 300,000 purpose-driven colleagues.

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Job Details
Category product
Posted 7 months ago