Healthcare Quality Champion - Claims & Service Excellence

CVS Health; Vermont; Hybrid; USD 25,000 - 53,000; Full time

Benefits offered by this job

Bonus eligibility

Comprehensive benefits

Paid time off

Job summary

CVS Health in Vermont seeks a Sr Quality Specialist to guide operations in claim processing and customer service, measuring quality and driving improvements. You will audit, monitor compliance, and influence cross-functional teams to raise service quality and cost efficiency.

The role requires health insurance experience and strong Excel skills; it offers full-time hours, a comprehensive benefits package, and eligibility for CVS Health incentive programs.

Qualifications

• 2+ years of health insurance work experience and/or Healthcare Insurance Quality Review.
• Moderate to advanced knowledge of Excel (V-lookups, pivot tables, and/or formulas).

Responsibilities

• Executes routine and non-routine business support tasks for the Sr Quality Specialist area under limited supervision.
• Follows area protocols, standards, and policies to provide effective and timely support.
• Acts as a subject matter expert on Quality Specialist workflows, policies, systems requirements, and enhancements.
• Conducts standard quality reviews and audits to monitor team compliance with policies and procedures.
• Owns responsibility for supporting targeted quality audit projects, reporting results, and recommending training needs and quality controls.

Skills

Health insurance

Quality review

Education

High School Diploma or GED

Tools

Excel

Job description

CVS Health in Vermont seeks a Sr Quality Specialist to guide operations in claim processing and customer service, measuring quality and driving improvements. You will audit, monitor compliance, and influence cross-functional teams to raise service quality and cost efficiency.

The role requires health insurance experience and strong Excel skills; it offers full-time hours, a comprehensive benefits package, and eligibility for CVS Health incentive programs.