Remote Medicare Stars and Quality, Senior Manager, RN- Great Lakes Region

CVS Health

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Job ID: 2458971BR
Category: Medicare
Remote: Fully Remote

Job Description
Candidates residing in Michigan highly preferred

Family Summary/Mission:
Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna. Health Services strategies, policies, and programs are comprised of utilization management, quality management, network management and clinical coverage and policies.

Position Summary:
This role is responsible for managing Medicare Advantage Star Ratings initiatives for the Great Lakes Medicare Market (N. IL, MI, IN, WI). This role works directly with 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.

*Involved in initiative planning, ongoing client relationship management and satisfaction for assigned initiatives that impact the delivery of products and services to the internal and external environment *Collaborates with 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.
*Participates as a team member, 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
*3+ years’ experience with Medicare Star Ratings and HEDIS
*5+ years’ experience working with physicians, hospitals, or health plans
*Proficiency with computer skills which includes navigating multiple systems & Microsoft Office applications (Outlook, Word, Excel, Power Point, etc.), including experience running web-based meetings
*Demonstrated strong data analysis with the ability to tell a story
*Effective communication skills required, both verbal and written.
*Excellent skills in the following areas: Project management, analytical, planning, influencing, organizational management. Also, time management and critical thinking skills
*Demonstrated relationship management skills; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.
*Demonstrated experience successfully implementing change in complex organizations.
*Experience with enterprise-wide and/or cross-functional large-scale initiatives with high degree of complexity.
*Region travel required to provider offices, clinics, facilities, or other locations as needed

Preferred Qualifications
*Active RN licensure and good standing for state of residence

Bachelor’s degree or equivalent recent and related 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.