Remote RN Quality Improvement Consultant

CVS Health; Central City (KY); Remote; USD 67,000 - 143,000; Full time

Benefits offered by this job

Medical coverage

Retirement savings options

Paid time off

Wellness programs

Job summary

CVS Health is seeking a Registered Nurse to lead quality improvement initiatives across healthcare services. You will analyze workflows, support POSC Council workplans, and drive performance toward HEDIS and CAHPS goals with evidence-based interventions.

Responsibilities include developing programs, coordinating workplans, educating staff, and ensuring compliance with regulatory standards. A BSN is required; RN license is essential, with 5–7 years of relevant experience preferred.

Qualifications

• 5–7 years in clinical, case management, administrative, quality/compliance or HEDIS roles
• In depth knowledge of managed care quality, HEDIS and STARs measures
• Strong interpersonal, analytical and writing skills
• Experience with data analytics and clinical requirements

Responsibilities

• Develops and implements quality improvement programs to monitor and improve healthcare services in line with standards.
• Drives evidence-based performance interventions and monitors process/outcome measures for POSC forums and councils.
• Coordinatess workplans and facilitates POSC workgroups to ensure stakeholder engagement.
• Contributes to improved patient outcomes and adherence to regulatory requirements.
• Contributes to policies/guidelines focusing on system performance and provider networks.
• Keeps up with healthcare innovations and disseminates findings to improve care.

Skills

RN experience

HEDIS/STARs knowledge

Quality improvement

Data analytics

Regulatory compliance

Communication skills

Clinical workflow analysis

Critical thinking

Team collaboration

Education

BSN

Master's degree in healthcare related field

CPHQ certification

Tools

CPHQ (certification)

Job description

CVS Health is seeking a Registered Nurse to lead quality improvement initiatives across healthcare services. You will analyze workflows, support POSC Council workplans, and drive performance toward HEDIS and CAHPS goals with evidence-based interventions.

Responsibilities include developing programs, coordinating workplans, educating staff, and ensuring compliance with regulatory standards. A BSN is required; RN license is essential, with 5–7 years of relevant experience preferred.