Health Care QM Manager

Profile

Job Description
Position Summary
This is a fully remote role open to candidates residing in any of the lower 48 states. This position will manage the Business Integrity Unit clinicians as well as provide leadership support for the Medicare OD auditing team.

Responsibilities include:
--Managing the Business Integrity Unit clinical audits and projects.
--Leading process improvement reviews/consultations with business partners.
--Identifying gaps in processes or organization and challenges self and others to develop and implement solutions.
--Working with internal clinical business partners to discuss specific compliance trends/opportunities for improvement
-- Medicare OD auditing oversight (including training opportunities, continuous monitoring support, Medicare Compliance request support)
-- High level report outs of key Medicare OD metrics.

Strongly preferred skills and competencies include:
-Strong communication skills and the ability to interact with and communicate to a variety of business partners including leadership
-Attention to detail and accuracy
-Adaptability and strong time management skills

Required Qualifications
Required Qualifications
-Project Management experience
-Skilled in Microsoft office programs: Work, Excel, PowerPoint,
-Skilled in meeting facilitation using Webex

COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
If you are vaccinated, you are required to have received at least one COVID-19 shot
prior to your first day of employment and to provide proof of your vaccination status within the first 10 days
of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days
of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with **MEMBERS ONLY**SIGN UP NOW***.
If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply
for a reasonable accommodation within the first 10 days
of your employment in order to remain employed with **MEMBERS ONLY**SIGN UP NOW***. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.
Preferred Qualifications
Preferred Qualifications
-Experience with QuickBase (data entry, development)
-Compliance/auditing experience
-Strong interpersonal skills to collaborate virtually with other business teams

Education
Education
- Bachelor's degree or equivalent experience preferred

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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