Senior Quality Consultant

CVS Health; United States; Remote; Full time

Job summary

CVS Health is seeking a document quality auditor to ensure compliance and quality of legal documentation for self-funded health plans. The ideal candidate will have 3-5 years of relevant experience and proficiency in Microsoft Office applications. Join a dedicated team that prioritizes improving healthcare accessibility and quality.

Benefits

401(k) plan (including matching contributions)

Affordable medical plan options

Flexible work schedules

Tuition assistance

Qualifications

• 3-5 years of plan writing experience supporting self-funded or fully insured plans.
• Adept at problem solving, decision making, and interpersonal communication.
• Strong attention to detail and ability to anticipate workload needs.

Responsibilities

• Quality check complex benefit information for self-funded plans.
• Analyze, draft, edit, and review all legal and regulatory plan documentation.
• Deliver high-quality documentation while meeting department standards.

Skills

Problem solving

Decision making

Communication

Critical thinking

Organization

Time management

Education

Associates degree or equivalent work experience

Tools

Microsoft Office Word

Microsoft Excel

SharePoint

Microsoft Outlook

Job description

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.

Position Summary

Quality check complex benefit information, including non-standard plan language into crisp, compliant, easy-to-understand plan language for self-funded plans. This includes analyzing, drafting, editing, and reviewing all legal and regulatory plan documentation (i.e., SPDs, plan amendments. SBCs and restates) for our self-funded plan customers.

Basic understanding of regulations, laws, and internal procedures impacting self-funded health plans with attention to ensuring the plan and company remain in compliance with federal and state law.

Successfully negotiate deadlines when appropriate; influences change/enhancement to business processes, policies, and system infrastructure to improve information quality, availability, and access.

Deliver high-quality documentation ensuring department standards are met with a focus on ensuring all errors in spelling, grammar, and formatting are corrected before the document is sent to the customer.

May participate in implementation of department projects as needed.

Other duties as assigned.

Required Qualifications

3-5 years of plan writing experience supporting self-funded or fully insured plans.

Proficiency with Microsoft Office Word, Excel, SharePoint and Outlook applications.

Preferred Qualifications

Adept at problem solving and decision making skills.

Quality Improvement Associate Certification (CQIA).

Interpersonal skills to include written and verbal communication, critical thinking, persuasiveness, advising and counseling skills.

Ability to anticipate workload needs and to follow through with minimum direction.

Effective time management, organizational and prioritization skills.

Strong attention to detail and accuracy performing at high levels in a fast paced and constantly changing work environment.

Education

Associates degree or equivalent work experience.

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.

Position Summary

• Quality check complex benefit information, including non-standard plan language into crisp, compliant, easy-to-understand plan language for self-funded plans. This includes analyzing, drafting, editing, and reviewing all legal and regulatory plan documentation (i.e., SPDs, plan amendments. SBCs and restates) for our self-funded plan customers.

• Basic understanding of regulations, laws, and internal procedures impacting self-funded health plans with attention to ensuring the plan and company remain in compliance with federal and state law.

• Successfully negotiate deadlines when appropriate; influences change/enhancement to business processes, policies, and system infrastructure to improve information quality, availability, and access.

• Deliver high-quality documentation ensuring department standards are met with a focus on ensuring all errors in spelling, grammar, and formatting are corrected before the document is sent to the customer.

• May participate in implementation of department projects as needed.

• Other duties as assigned.

Required Qualifications

• 3-5 years of plan writing experience supporting self-funded or fully insured plans.

• Proficiency with Microsoft Office Word, Excel, SharePoint and Outlook applications.

Preferred Qualifications

• Adept at problem solving and decision making skills.

• Quality Improvement Associate Certification (CQIA).

• Interpersonal skills to include written and verbal communication, critical thinking, persuasiveness, advising and counseling skills.

• Ability to anticipate workload needs and to follow through with minimum direction.

• Effective time management, organizational and prioritization skills.

• Strong attention to detail and accuracy performing at high levels in a fast paced and constantly changing work environment.

Education

• Associates degree or equivalent work experience.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $42.35

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: 06/27/2025

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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