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CVS Health Senior Analyst, Health Care Quality Management in Downers Grove, Illinois

Job Description

Shift: 8:00 AM - 5:00 PM (Monday - Friday)*Ability to adopt flexible schedule as neededThe Senior Analyst is responsible for reporting and analytic data needs of the health plan’s Quality and Compliance Operations team, handling complex data projects.ESSENTIAL FUNCTIONS:• Provide advanced analytical support for business operations in all or some of the following areas: claims, provider data, member data, clinical data, HEDIS, CAHPS, external reporting• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management• Leverage business acumen and good data storytelling to help Aetna improve member well-being, provider performance and its product and services• Develop reports and deliverables for management (including statistical analyses, segmentation, modeling, etc.)• Model data using MS Excel, Access, SQL, and/or other data warehouse analytical tools• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis.• Build and maintain strong professional relationships internally and with leaders and staff of provider organizations• Supports assessment of provider performance patterns, strengths and challenges utilizing NCQA, HEDIS, Medicaid Stars, state, and regulatory standards• Use advanced communication, presentation, and facilitation skills to communicate the strategy needed to achieve the objectives for health plan performance improvement• Performs other duties and projects as assigned.

Pay Range

The typical pay range for this role is:

Minimum: 43,700

Maximum: 100,000

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit


Required Qualifications

• 2+ years of managed care experience or health care experience, Medicaid preferred• 2+ years of HEDIS and/or health plan quality experience required, Medicaid preferred• 3+ years experience as an experienced analyst in business analysis, business systems or both• Data analysis with big data experience, visualizations, and some statistics knowledge, including with HEDIS reporting and data analytics

Preferred Qualifications

• 3+ years experience using Microsoft Office programs (excel, word, PowerPoint)• Knowledge base with HEDIS reporting engines• Knowledge base in Medicaid HEDIS reporting and analytics• Strong interpersonal communication skills


Bachelors Degree or equivalent work experience

Business Overview

Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. 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.