Health Outcomes Accreditation Lead: Equity & Compliance

CVS Health; Maryland; Hybrid; USD 68,000 - 199,000; Full time

Benefits offered by this job

Comprehensive benefits package

Hybrid work policy

Equity award program

Job summary

CVS Health seeks a senior professional to lead NCQA Health Outcomes and Community-Focused Care accreditation initiatives, driving readiness, gap analysis, corrective actions, and performance improvement across health plan populations.

You will partner with clinical, quality, compliance, and analytics teams to align accreditation with strategic priorities, ensuring equitable care and successful survey outcomes.

Qualifications

• 3-5 years as a subject matter expert on NCQA Health Outcomes Accreditation and Community-Focused Care (CFC) standards.
• 3-5 years accreditation readiness activities including gap assessments, standards implementation, document reviews, mock surveys, corrective action planning, and ongoing compliance monitoring.
• Partners with operational, clinical, quality, compliance, population health, care management, network, member experience, and analytics teams to integrate accreditation requirements into strategic and operational business processes.
• Evaluates organizational performance against accreditation standards and quality goals, identifying compliance risks, improvement opportunities, and actionable recommendations.
• Leads cross-functional teams, workgroups, and governance committees to support accreditation, health equity, quality improvement, and organizational performance objectives.
• Accountable for the design, development, implementation, and oversight of accreditation, quality improvement, and health equity initiatives that support organizational goals and improved health outcomes.
• Develops executive-level reports, presentations, readiness assessments, and governance materials to communicate accreditation status, risks, accomplishments, and strategic priorities.

Responsibilities

• Leads NCQA Accreditation activities including standards interpretation, readiness assessments, gap analysis, documentation review, survey preparation, corrective action planning, and ongoing accreditation maintenance.
• Serves as the organization's subject matter expert for NCQA Health Outcomes and Community-Focused Care Accreditation requirements and emerging health equity standards, partnering with operational teams to integrate equitable care practices and improve outcomes.
• Develops and delivers accreditation strategies, executive presentations, governance reporting, and action plans in collaboration with business owners and cross-functional partners.
• Manages multiple complex accreditation and quality improvement initiatives, ensuring milestones, deliverables, and regulatory requirements are achieved.
• Proactively builds strong business relationships with internal and external business partners, linking quality management activities to business goals and leads cross functional teams to assist business units with quality activities.
• Supports additional accreditation, certification, quality, and regulatory initiatives as assigned, providing consultation and project leadership across business areas.

Skills

NCQA Accreditation expertise

Quality improvement leadership

Stakeholder collaboration

Regulatory compliance

Health equity focus

Education

Bachelor's degree or higher in a related field

Job description

CVS Health seeks a senior professional to lead NCQA Health Outcomes and Community-Focused Care accreditation initiatives, driving readiness, gap analysis, corrective actions, and performance improvement across health plan populations.

You will partner with clinical, quality, compliance, and analytics teams to align accreditation with strategic priorities, ensuring equitable care and successful survey outcomes.