Remote Hybrid Medicare Star Ratings Nurse Senior Manager

CVS Health

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Job ID: 2540905BR
Category: Nurse
Location: Jackson, MS
Remote: Hybrid

Job Description
Work at home with strong preference to reside in Market (Mississippi).

Standard business hours Monday-Friday.

Approximately 10-15% of expected travel to meet provider groups in person.

This role is responsible for leading Medicare Advantage Star Ratings initiatives for the Georgia & the Gulf States Medicare Market (Mississippi). This role works directly with key value-based provider groups and their staff to close clinical and pharmacy quality measure gaps. This position will meet regularly with internal and external leaders and stakeholder to review provider performance and formulate tactics to facilitate continuous improvement. This role also works directly with members to schedule provider visits to address gap closure and supports development/execution of local market initiatives to improve Star Ratings.

Accountable for designing conceptual models, contracting, initiative planning, business results and ongoing client relationship management and satisfaction for smaller to moderate scale and complexity high value initiatives and parts of larger initiatives that impact the delivery of products and services to the internal and external environment . Responsible for providing guidance and direction to external vendors, external consultants, consulting team members and/or matrixed staff as required in support of initiatives. Accountable for transferring knowledge, best practices (external and internal), methodology and tools to client organizations. May be responsible for concurrent initiatives as team lead and/or team member, based on resource requirements.

Pay Range
The typical pay range for this role is:
Minimum: 75,400
Maximum: 162,700

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
– Must have active and unrestricted RN licensure in state of residence
– 5+ years experience with Medicare Star Ratings and HEDIS
– 7+ years experience working with physicians, hospitals, or health plans
– Must reside in the state of Mississippi or bordering states including Louisiana, Arkansas, Alabama and Tennessee
– 3+ years of experience using Microsoft Office applications (Outlook, Word, Excel, Power Point, etc.), including experience running web-based meetings.
– Willing and able to travel 10-15% of the time. Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy

Preferred Qualifications
– Additional experience with PQA, CAHPS and HOS.
– Management consulting, project consulting, business process consulting, strategic business planning,
– Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.
-Demonstrated leadership with relevant initiatives: Business process, enterprise business project management/consulting, financial strategic planning and analysis, mergers and acquisitions, strategic planning, risk management.
-Demonstrated superior business process, project management and organizational redesign experience.
-Demonstrated experience successfully implementing change in complex organizations.
-Experience with enterprise-wide and/or cross-functional large-scale initiatives with high degree of complexity.

BSN minimum required. Masters degree preferred, but not required

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.