Remote Quality Improvement Nurse Consultant

CVS Health; Kentucky; Remote; USD 67,000 - 143,000; Full time

Job summary

CVS Health is seeking a Registered Nurse with 5-7 years of experience in quality and performance improvement to lead and support HEDIS, CAHPS and regulatory initiatives. You will analyze workflows, drive evidence-based interventions, and help implement and measure POSC Council workplans to improve care quality.

You will collaborate across clinical teams and stakeholders, stay current with industry standards, provide training on HEDIS/CAHPS, and help ensure patient safety and high-quality service

Qualifications

• 5-7 years prior relevant work experience in clinical, case management, administrative, quality/compliance or HEDIS roles.
• In depth knowledge of managed care quality, HEDIS and STARs measures and performance initiatives.
• Excellent interpersonal, critical thinking and analytic skills.
• Experience with quantitative/qualitative data analytics and clinical requirements.
• Ability to work with diverse clinical staff and patients with tact and integrity.
• Strong communication, presentation and technical writing skills.
• RN licensure required. Collaboration and execution skills essential.

Responsibilities

• Develops and implements quality improvement programs to monitor and improve healthcare processes.
• Drives evidence-based performance improvements, tracks measures, and prepares materials for POSC discussions.
• Manages workplans for POSC workgroups and facilitates relevant committees.
• Contributes to enhancing services, patient outcomes, and regulatory adherence.
• Supports policy development to improve system performance and reduce disparities.
• Stays current on quality research and facilitates knowledge transfer to practice.
• Provides training to healthcare professionals on HEDIS and CAHPS related performance.

Skills

RN required

HEDIS knowledge

Quality improvement

Data analytics

Collaboration

Education

BSN required

Masters degree preferred

Job description

CVS Health is seeking a Registered Nurse with 5-7 years of experience in quality and performance improvement to lead and support HEDIS, CAHPS and regulatory initiatives. You will analyze workflows, drive evidence-based interventions, and help implement and measure POSC Council workplans to improve care quality.

You will collaborate across clinical teams and stakeholders, stay current with industry standards, provide training on HEDIS/CAHPS, and help ensure patient safety and high-quality service