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CVS Health Quality Project Lead in New York

Job Description

•Acts as an advocate for, and support for the business. This is accomplished by serving as a quality champion through measuring and monitoring the quality and effectiveness of work processes, directly impacting customer satisfaction and operational efficiency. •Consult and/or work cross functionally to influence and promote change in order to continually deliver quality service to our internal and external customers.•Responsible for conducting highly complex quality management, procedural documentation, and/or special analysis audits and projects. •Manages contractually required audits involving significant financial value and risk. •Oversees multiple concurrent projects including planning, execution, evaluation and formulating corrective actions. •Serves as subject matter expert in Quality Management, auditing practices, financial calculations, benefits, systems, external audits, internal audits, and internal controls. •Serves as team leader to plan, organize, and facilitate multiple, concurrent projects of high complexity. •Drafts the audit issues and reports for each assigned project that effectively communicates the purpose of the project and conclusions reached in a manner appropriate for senior leadership. •Manages project resource needs, identifies and communicates resource/administrative gaps, and works with department management to secure necessary resources to meet project objectives. •Participates in department wide activities such as training and staff development as well as management presentations to other Aetna areas. •Provides oversight in the completion of process improvements, for each project. Tests that interventions/solutions were effective in remediating and improving the quality of work for that which was in scope for the project. •Works with business leadership and their staff as necessary to review project findings, draft solutions, track corrective action plans, and track the installation of improvement solutions.

Required Qualifications

•Experience with Medicare Advantage products.

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 30 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 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.

  • 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 30 days of your employment in order to remain employed with CVS Health. 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

•Should have significant project management experience within Medicare Advantage and or related field.•Ideally extensive experience (7 years or more) with vendors that provide supplemental benefits (such as dental, fitness, meals, and transportation). Audit or related business experience with insurance, demonstrating high proficiency in the competencies noted.

Education

•Bachelor’s Degree or relevant experience in lieu of degree.•Preferred to have a degree in Public Health, Health Care Informatics, Risk Management, Insurance, or related field of study. Advanced degree 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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