Remote QM Nurse Consultant, IL

CVS Health

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Remote
IL – Work from home
Full time
Posted Today
R0175991

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.

 

 

 

Position Summary

The QM Consultant has a key role in developing and implementing data-driven strategies/interventions that support the delivery of high quality health benefits and services for members. The QM Consultant manages specific vendor relationships that support member engagement and promote increased access to health care and services and to close quality and health equity gaps. The QM Consultant drives value through driving these partnerships and strategic interventions to improve member experience with Aetna and related HEDIS rates. This role has responsibility for the design, content and reporting of member and provider incentive programs, as well as tracking and measuring effectiveness of those incentives. The QM Consultant coordinates, prepares and delivers committee reports, reviews documentation and interprets data in line with HEDIS, regulatory, and accreditation requirements for patterns, population outcomes and to support the achievement of organizational quality goals.

Required Qualifications
-3+ years experience in clinical, managed care, or health related field.

-RN license in the state of their residence.

Preferred Qualifications
Certification in project management and / or health care quality
Education
Bachelor’s degree required, masters degree in related field preferred

 

 

Pay Range

The typical pay range for this role is:

 

$63,200.80 – $136,600.00

 

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 jobs.CVSHealth.com/benefits

 

 

 

We anticipate the application window for this opening will close on: 04/23/2024