Remote RN Quality Improvement & Performance Consultant

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

Benefits offered by this job

Medical, dental, vision coverage

PTO and vacation

Retirement savings

Wellness programs

Job summary

CVS Health is seeking a Quality Improvement Lead focused on HEDIS and CAHPS to analyze workflows and drive performance improvements in care delivery. The role requires 5–7 years in clinical, case management, quality, or HEDIS roles, with RN licensure and a BSN.

You will develop and implement quality programs, coordinate POSC workplans, train staff, and ensure regulatory alignment while collaborating with POSC stakeholders to advance care quality goals. A Master’s in healthcare is preferred.

Qualifications

• Minimum 5–7 years in clinical, case management, quality/compliance or HEDIS roles.
• Knowledge of HEDIS, STARs measures and managed-care quality initiatives.
• Ability to manage sensitive information ethically and collaboratively.

Responsibilities

• Develops and implements quality improvement programs to monitor and improve healthcare services and processes.
• Drives evidence-based performance improvements and tracks process/outcome measures for POSC forums and councils.
• Manages workplans for POSC workgroups and facilitates committees for stakeholder engagement.
• Contributes to improving patient outcomes and adherence to regulatory requirements.
• Develops policies and guidelines addressing system performance, provider networks, and health disparities.
• Keeps up-to-date on healthcare innovations and conducts research to improve care quality.
• Provides training on HEDIS and CAHPS performance to healthcare professionals and staff.
• Collaborates with POSC stakeholders to measure and evaluate best practices.

Skills

Interpersonal skills

Critical thinking

Analytic skills

Data analytics

Communication

Customer relations

Education

BSN

Master's degree in healthcare

RN licensure

Job description

CVS Health is seeking a Quality Improvement Lead focused on HEDIS and CAHPS to analyze workflows and drive performance improvements in care delivery. The role requires 5–7 years in clinical, case management, quality, or HEDIS roles, with RN licensure and a BSN.

You will develop and implement quality programs, coordinate POSC workplans, train staff, and ensure regulatory alignment while collaborating with POSC stakeholders to advance care quality goals. A Master’s in healthcare is preferred.