Health Outcomes Accreditation Lead (Hybrid)

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

Benefits offered by this job

Comprehensive benefits package

Bonus eligibility

Equity awards

Job summary

CVS Health is seeking a senior leader to drive NCQA Health Outcomes (HOA) and Community-Focused Care (CFC) accreditation initiatives, shaping quality improvement and compliance across health plan populations.

You will design, implement, and continuously evaluate strategies, readiness activities, gap analyses, corrective action planning, and performance improvement initiatives to promote equitable health outcomes.

Qualifications

• 3-5 years as a subject matter expert on NCQA Health Outcomes Accreditation and CFC standards.
• 3-5 years accreditation readiness activities including gap assessments, standards implementation, document reviews, mock surveys, corrective action planning.
• Partners with operational, clinical, quality, compliance, population health, care management, analytics to integrate accreditation requirements.
• Evaluates performance against standards and quality goals, identifying risks and improvement opportunities.
• Leads cross-functional teams and governance to support accreditation and health equity objectives.
• Oversees design, development, and oversight of accreditation, quality improvement, and health equity initiatives.
• Develops executive reports, readiness assessments, and governance materials to communicate status and priorities.
• Drives enhancements to processes, policies, and infrastructure to improve compliance and performance.
• Performs strategic analysis of data to identify trends and support decisions.
• Collaborates with leaders to develop new programs supporting accreditation and quality objectives.
• Monitors emerging requirements and assesses impact, recommending readiness strategies.
• Serves as a technical expert translating requirements into actionable plans.
• May manage a quality management function including metrics and policy application.
• May manage additional accreditation activities as needs evolve.
• Regular attendance and travel as required.
• Demonstrates problem-solving, organization, attention to detail and independence.

Responsibilities

• Leads NCQA Accreditation activities including standards interpretation, readiness assessments, gap analysis, documentation review, survey preparation, corrective action planning.
• Serves as SME for NCQA HOA and CFC requirements, partnering with teams to integrate equitable care practices.
• Develops and delivers accreditation strategies, governance reporting, and action plans with cross-functional partners.
• Manages multiple accreditation and quality initiatives, ensuring milestones and regulatory requirements are met.
• Builds relationships with internal and external partners, linking quality activities to business goals.
• Supports additional accreditation, certification and regulatory initiatives as assigned.

Skills

NCQA Health Outcomes

CFC Accreditation

Quality Improvement

Health Equity

Regulatory Compliance

Cross-functional Leadership

Education

Bachelor's Degree

Master's Degree

Job description

CVS Health is seeking a senior leader to drive NCQA Health Outcomes (HOA) and Community-Focused Care (CFC) accreditation initiatives, shaping quality improvement and compliance across health plan populations.

You will design, implement, and continuously evaluate strategies, readiness activities, gap analyses, corrective action planning, and performance improvement initiatives to promote equitable health outcomes.