Practice Transformation Advisor - Behavioral Health

4004 Aetna Medicaid Administrators; Louisiana; Hybrid; USD 54,000 - 119,000; Full time

Benefits offered by this job

Comprehensive health benefits

Bonus eligibility

Job summary

CVS Health is looking for a remote Behavioral Health Quality Improvement professional to partner with providers, health systems and centers to improve quality measures and adoption of best practices.

The role focuses on improving FUH and FUM/FUA metrics, enhancing data exchange and provider engagement, and supporting transitions across inpatient, ED and outpatient settings. Requires 5–7 years in healthcare quality, HEDIS knowledge, and licensure.

Qualifications

• 5-7 years of healthcare quality improvement, provider relations, or a related role.
• In-depth knowledge of HEDIS, healthcare regulations, clinical operations, quality standards, and performance metrics.
• Licensed Allied Health Professional or Licensed RN or LPN with active licensure.
• Strong analytical and problem-solving skills to interpret data and identify improvement opportunities.
• Excellent communication and interpersonal skills to influence provider groups and executives.

Responsibilities

• Drive improvement in behavioral health quality measures and provider adoption of evidence-based workflows.
• Strengthen provider accountability for quality performance and improve transition-of-care management.
• Serve as the provider-facing liaison for behavioral health initiatives and data-sharing efforts.
• Support implementation and optimization of ADT feed participation with behavioral health and hospital providers.
• Ensure access to timely clinical information for intervention and follow-up activities.

Skills

Healthcare quality improvement

Provider relations

Data analysis

HEDIS knowledge

Regulatory knowledge

Communication

Education

Bachelor's degree

Licensed Allied Health Professional

RN/LPN license

Tools

Excel

Data visualization software

Electronic Health Record (EHR) systems

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Must reside in Louisiana for this role. The Behavioral Health PTA serves as the primary provider-facing resource responsible for partnering with behavioral health providers, community mental health centers, health systems, and integrated delivery organizations to improve quality performance and adoption of best practices.

Strategic Value The position will:

Drive improvement in behavioral health quality measures. Support provider adoption of evidence-based behavioral health workflows. Strengthen provider accountability for quality performance. Improve transition-of-care management between inpatient, ED, and outpatient settings. Serve as the provider-facing liaison for behavioral health performance initiatives. Support implementation and optimization of ADT feed participation with behavioral health and hospital providers. Improve access to timely clinical information needed for intervention and follow-up activities. Advance interoperability and data-sharing capabilities across the behavioral health provider network.

Expected Outcomes

• Improved Follow-Up After Hospitalization for Mental Illness (FUH).
• Improved Follow-Up After Emergency Department Visit for Mental Illness and Substance Use Disorder (FUM/FUA).
• Increased provider participation in data exchange initiatives.
• Improved access to real-time admission, discharge, and transfer notifications.
• Enhanced provider engagement and practice adoption of quality improvement strategies.
• Better identification and intervention for high-risk members.

Requirements:

• 5-7 years of experience in healthcare quality improvement, provider relations, or a related role.
• In-depth knowledge of HEDIS, healthcare regulations, clinical operations, quality standards, and performance metrics.
• Licensed Allied Health Professional or Licensed Registered Nurse or LPN
• 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. Must being willing to travel to provider sites as needed. This is rare but required if requested.

Preferred:

• Coding or Provider facing, Clinical experience, or Provider Practice experience
• Certified Six Sigma Green Belt
• Certified Professional in Healthcare Quality (CPHQ) or equivalent

Education:

Bachelors Degree or equivalent experience/clinical training and licensure

Anticipated Weekly Hours 40

Time Type Full time

Pay Range

The typical pay range for this role is: $54,300.00 - $119,340.00 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 10/21/2026

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

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.