Sr Analyst OhioRISE Prevention & Wellness

4004 Aetna Medicaid Administrators; Kentucky; Hybrid; USD 47,000 - 102,000; Full time

Benefits offered by this job

Comprehensive benefits

Bonus eligibility

Job summary

CVS Health is seeking a Population Health Specialist to lead OhioRISE initiatives, collaborating with MCOs, vendors, and ODM to advance population health outcomes for children with complex needs.

The role focuses on data-driven improvement, stakeholder engagement, and regulatory compliance, with a strong emphasis on Six Sigma/Lean methodologies and quality improvement tools. This is a full-time remote position with travel up to 10% within Ohio.

Qualifications

• Minimum 3 years experience in health care or public health with a preferred focus on quality improvement, population health, care management, social work, or behavioral health.
• At least 1 year experience in population health or quality improvement role.
• Must reside in Ohio.

Responsibilities

• Lead population health projects to improve health outcomes for the OhioRISE populations using the Institute for Healthcare Improvement model.
• Ensure timely management and continual updating of documentation to reflect ongoing changes and outcomes.
• Oversee and drive consistent progress in intervention testing.
• Analyze complex data sets to identify emerging trends and design, test, and evaluate targeted interventions for improvement.
• Serve as a subject matter expert on quality improvement methodologies and tools.
• Deliver presentations to internal and external stakeholders.
• Collaborate with the Ohio Department of Medicaid, Case Western Center of Excellence, Care Management Entities, internal teams and other key stakeholders to develop and implement population health strategies and interventions.
• Support quality improvement initiatives as needed.
• Provide updates and supporting documents for state RFP, NCQA and EQRO reviews and proposal submissions.
• Assist in ensuring the Plan meets all regulatory requirements as outlined in the Provider Agreement and other accrediting agencies policies.

Skills

Quality improvement

Data analysis

Project management

Communication

Education

Bachelor’s degree in public health, health administration, social work, or related field

Tools

Microsoft Word

Excel

PowerPoint

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.

Position Summary

As part of the bold vision to deliver the “Next Generation” of managed care in Ohio Medicaid, Ohio RISE will help struggling children and their families by focusing on the individual with strong coordination and partnership among MCOs, vendors, and ODM to support specialization in addressing critical needs. The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral health needs involved in, or at risk for involvement in, multiple child-serving systems. The Population Health Specialist (PHS) leads initiatives to advance health outcomes and reduce disparities for the OhioRISE population. This role applies quality improvement science to lead efforts improving health outcomes for OhioRISE members by identifying disparities and implementing targeted interventions. The PHS analyzes population health data to uncover trends, gaps in care, and opportunities for system‑level improvement. Designs and executes quality improvement projects to address identified needs by collaborating with diverse stakeholders, including internal care coordination teams, hospital systems, the Ohio Department of Medicaid, Case Western Center of Excellence, and Care Management Entities. Monitors, evaluates, and reports on the effectiveness of population health interventions to ensure measurable impact. Serves as a quality improvement methodology subject matter expert within the OhioRISE program. This is a full time telework position with occasional travel required (within Ohio) as determined by business need - residing in Ohio is strongly preferred.

Primary Responsibilities

• Using the Institute for Healthcare Improvement model, this individual will lead population health projects to improve health outcomes for the OhioRISE populations.
• Ensure timely management and continual updating of documentation to reflect ongoing changes and outcomes.
• Oversee and drive consistent progress in intervention testing.
• Analyze complex data sets to identify emerging trends and design, test, and evaluate targeted interventions for improvement.
• Serves as a subject matter expert on quality improvement methodologies and tools.
• Deliver presentations to internal and external stakeholders.
• Collaborate with the Ohio Department of Medicaid, Case Western Center of Excellence, Care Management Entities, internal teams and other key stakeholders, including Medicaid managed care plans, community organizations, members/families, and healthcare providers, to develop and implement population health strategies and interventions.
• Support quality improvement initiatives as needed.
• Provides necessary updates as needed and supporting documents for state RFP, NCQA and EQRO reviews and proposal submissions.
• Assisting in ensuring the Plan meets all regulatory requirements as outlined in the Provider Agreement and other accrediting agencies policies.
• Under the direction of the Director of Population Health, develops the annual Population Health Strategy, including assessments on enrollee participation and program impact.
• Ability to travel up to 10% of the time in Ohio to office and state meetings.
• Must have reliable transportation.
• Valid/active driver’s license, and proof of vehicle insurance.
• Performs additional responsibilities and tasks as required to support team and organizational objectives.

Required Qualifications

• Minimum 3 years experience in health care or public health with a preferred focus on quality improvement, population health, care management, social work, or behavioral health.
• At least 1 year experience in population health or quality improvement role.
• Must reside in Ohio.

Preferred Qualifications

• Experience with Improvement methodologies (Six Sigma, Lean, IHI Model) is strongly preferred.
• Proficient in Microsoft Word, Excel, and PowerPoint.
• Embraces change and remains flexible when faced with evolving priorities or ambiguous situations.
• Strong analytical, communication, and project management skills.
• Self-motivated and demonstrated ability to work independently.
• Ability to build collaborative relationships with internal and external stakeholders.
• Experience working with Medicaid populations is strongly preferred.

Education

Bachelor’s degree in public health, health administration, social work, or a related field, or equivalent work experience.

Hours & Employment Type

Anticipated Weekly Hours 40 Time Type Full time

Pay Range

The typical pay range for this role is: $46,988.00 - $102,000.00 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: 10/30/2026

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.