Quality - Practice Transformation Advisor

CVS Health; United States; Remote; USD 66,000 - 146,000; Full time

Job summary

CVS Health seeks a Quality Practice Transformation Advisor to enhance the quality of patient care. This position entails engaging with healthcare providers, performing quality analyses, and training staff to improve overall service delivery, with a strong focus on performance metrics and compliance.

Benefits

401(k) plan with company matching

Affordable medical plan options

Employee stock purchase plan

Tuition assistance

Flexible work schedules

Qualifications

• 5-7 years of experience in healthcare quality improvement or related roles.
• In-depth knowledge of healthcare regulations and quality standards.
• Proficiency in data management and analysis tools.

Responsibilities

• Establish provider engagement and conduct performance analysis.
• Lead performance improvement initiatives and maintain compliance.
• Utilize data analytics to report on provider performance.

Skills

Analytical skills

Problem-solving

Communication

Interpersonal skills

Education

Bachelor's degree in healthcare administration

Tools

Excel

Data visualization software

Job description

Quality - Practice Transformation Advisor

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

*APPLICANTS MUST RESIDE IN ILLINOIS*

The Quality Practice Transformation Advisor plays a critical role in supporting the highest standards of practice performance and quality within our organization's network of healthcare providers. The primary focus is to identify
areas for quality improvement, partner with provider practices to implement quality strategies that improve quality and cost of care, member, and clinician experience, and drive positive outcomes in the delivery of patient
care.

Responsibilities:

1. Provider Engagement: Establish and maintain engagement with large provider groups that have a membership of 1,000 or greater.
2. Performance Analysis: Conduct comprehensive analysis of provider performance metrics as well as clinical operations for VBC readiness and risk assessment. This includes clinical quality indicators, patient and provider
satisfaction ratings and operational efficiency measures. Identify areas of improvement and develop data-driven strategies to improve provider performance and financial rewards.
3. Provider Education and Practice Transformation: Collaborate with cross-functional teams to assess practice operations against industry best practices in primary care. Design and deliver training programs, workshops, and educational materials for primary care and specialty providers and their staff in key operational domains to achieve improved health outcomes. Facilitate sessions on clinic operations, quality standards, regulatory compliance, member experience and patient-centered care to enhance provider skills and knowledge.
4. Performance Improvement Initiatives: Lead initiatives aimed at improving provider performance. Develop and implement performance improvement plans, monitor progress, and evaluate the effectiveness of
interventions in collaboration with practice partners.
5. Quality Assurance: Conduct regular audits, reviews, and assessments of provider practices, documentation and compliance. Provide feedback and recommendations for improvement.
6. Stakeholder Collaboration: Collaborate closely with internal teams, including clinical and operational leadership, value-based care, quality management teams and provider relations teams to align provider
performance objectives with organizational goals. Foster effective working relationships with providers, offering guidance, feedback, and support to facilitate their success.
7. Data Management and Reporting: Utilize data management systems and analytics tools to collect, analyze, and report provider performance data. Prepare comprehensive reports, dashboards, and presentations for
senior leadership, highlighting key performance indicators, trends, and improvement opportunities.
8. Industry Knowledge and Research: Stay abreast of industry trends, best practices, and regulatory changes related to provider performance and healthcare quality. Support population health and health equity initiatives to improve care gap closure rates and health outcomes. Conduct research and benchmarking
activities to identify innovative approaches and opportunities for improvement.

Requirements:
5-7 years of experience in healthcare quality improvement, provider relations, or a related role.
In-depth knowledge of healthcare regulations, clinical operations, quality standards, and performance metrics.
Strong analytical and problem-solving skills, with the ability to interpret complex data sets and identify improvement opportunities.
Excellent communication, presentation and interpersonal skills to collaborate with and effectively influence provider groups and executives, , team members, and stakeholders at all levels.
Proven experience in designing and delivering training programs or educational initiatives.
Proficiency in data management and analysis tools, such as Excel or data visualization software.
Familiarity with electronic health record systems and healthcare information technology.
Detail-oriented, organized, and able to manage multiple projects simultaneously.
Ability to work independently, demonstrate initiative, and drive results in a fast-paced environment.
Position is remote – secure home network required and familiar with Microsoft Office products and VPN.

Preferred:
Licensed Allied Health Professional or Licensed Registered Nurse
Coding or Sales background
Certified Six Sigma Green Belt
Certified Professional in Healthcare Quality (CPHQ) or equivalent
Certified NCQA PCMH Content Expert

Education/license requirements:
• Bachelor's degree or commensurate work experience in healthcare

administration, public health, or a related field

Anticipated Weekly Hours

40

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

*APPLICANTS MUST RESIDE IN ILLINOIS*

The Quality Practice Transformation Advisor plays a critical role in supporting the highest standards of practice performance and quality within our organization's network of healthcare providers. The primary focus is to identify
areas for quality improvement, partner with provider practices to implement quality strategies that improve quality and cost of care, member, and clinician experience, and drive positive outcomes in the delivery of patient
care.

Responsibilities:

1. Provider Engagement: Establish and maintain engagement with large provider groups that have a membership of 1,000 or greater.
2. Performance Analysis: Conduct comprehensive analysis of provider performance metrics as well as clinical operations for VBC readiness and risk assessment. This includes clinical quality indicators, patient and provider
satisfaction ratings and operational efficiency measures. Identify areas of improvement and develop data-driven strategies to improve provider performance and financial rewards.
3. Provider Education and Practice Transformation: Collaborate with cross-functional teams to assess practice operations against industry best practices in primary care. Design and deliver training programs, workshops, and educational materials for primary care and specialty providers and their staff in key operational domains to achieve improved health outcomes. Facilitate sessions on clinic operations, quality standards, regulatory compliance, member experience and patient-centered care to enhance provider skills and knowledge.
4. Performance Improvement Initiatives: Lead initiatives aimed at improving provider performance. Develop and implement performance improvement plans, monitor progress, and evaluate the effectiveness of
interventions in collaboration with practice partners.
5. Quality Assurance: Conduct regular audits, reviews, and assessments of provider practices, documentation and compliance. Provide feedback and recommendations for improvement.
6. Stakeholder Collaboration: Collaborate closely with internal teams, including clinical and operational leadership, value-based care, quality management teams and provider relations teams to align provider
performance objectives with organizational goals. Foster effective working relationships with providers, offering guidance, feedback, and support to facilitate their success.
7. Data Management and Reporting: Utilize data management systems and analytics tools to collect, analyze, and report provider performance data. Prepare comprehensive reports, dashboards, and presentations for
senior leadership, highlighting key performance indicators, trends, and improvement opportunities.
8. Industry Knowledge and Research: Stay abreast of industry trends, best practices, and regulatory changes related to provider performance and healthcare quality. Support population health and health equity initiatives to improve care gap closure rates and health outcomes. Conduct research and benchmarking
activities to identify innovative approaches and opportunities for improvement.

Requirements:
5-7 years of experience in healthcare quality improvement, provider relations, or a related role.
In-depth knowledge of healthcare regulations, clinical operations, quality standards, and performance metrics.
Strong analytical and problem-solving skills, with the ability to interpret complex data sets and identify improvement opportunities.
Excellent communication, presentation and interpersonal skills to collaborate with and effectively influence provider groups and executives, , team members, and stakeholders at all levels.
Proven experience in designing and delivering training programs or educational initiatives.
Proficiency in data management and analysis tools, such as Excel or data visualization software.
Familiarity with electronic health record systems and healthcare information technology.
Detail-oriented, organized, and able to manage multiple projects simultaneously.
Ability to work independently, demonstrate initiative, and drive results in a fast-paced environment.
Position is remote – secure home network required and familiar with Microsoft Office products and VPN.

Preferred:
Licensed Allied Health Professional or Licensed Registered Nurse
Coding or Sales background
Certified Six Sigma Green Belt
Certified Professional in Healthcare Quality (CPHQ) or equivalent
Certified NCQA PCMH Content Expert

Education/license requirements:
• Bachelor's degree or commensurate work experience in healthcare

administration, public health, or a related field

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$66,330.00 - $145,860.00

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 07/25/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

About the company

At CVS Health, we share a clear purpose: helping people on their path to better health. Through our health services, plans and community pharmacists, we’re pioneering a bold new approach to total health. Making quality care more affordable, accessible, simple and seamless, to not only help people get well, but help them stay well in body, mind and spirit.

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