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**
The **Quality Data Specialist** leverages technology and data to improve healthcare outcomes by designing, implementing, and maintaining health information systems, analyzing quality healthcare data, and applying statistical analysis to create effectiveness analyses, as well as other health outcomes analyses. This person will apply expertise in healthcare and information technology to ensure efficient data management, promote data-driven insights, and enhance the delivery of healthcare services. They will also provide support in completing regulatory reporting requirements and contributes to the development and execution of HEDIS ( _Healthcare Effectiveness Data and Information Set_ ) strategy to ensure compliance and optimize performance in quality measurement initiatives.
**Responsibilities include:**
+ Analyzing and interpreting complex Quality and HEDIS-related data, including healthcare quality measures, patient outcomes, and performance indicators, in order to support strategic initiatives and improve compliance with national benchmarks.
+ Developing and implementing HEDIS strategy and quality assurance programs to ensure alignment with regulatory requirements, accreditation standards, and industry best practices.
+ Conducting intervention analysis to evaluate the effectiveness of quality improvement initiatives, identify gaps in care, and recommend targeted actions to optimize outcomes.
+ Performing routine audits and assessments to monitor adherence to company-established quality standards and regulatory reporting requirements, identifying core areas for improvement.
+ Examining and reporting on quality measures, patient safety indicators, and HEDIS performance metrics to highlight areas of success and opportunities for improvement.
+ Coordinating process mapping, root cause analysis, and workflow redesign to enhance healthcare processes, reduce errors, and improve efficiency.
+ Applying in-depth knowledge and experience in external audits, surveys, and regulatory reporting, ensuring timely and accurate submission of required documentation to governing bodies.
+ Preparing comprehensive reports and presentations to communicate findings, trends, and strategic recommendations to stakeholders, including senior leadership, quality improvement teams, and regulatory agencies
**Required Qualifications**
+ 3+ years of experience with HEDIS and/or quality, specifically in a managed care, hospital, and/or similar healthcare environment.
+ 3+ years of experience in Microsoft Office Suite, particularly Microsoft Excel and PowerPoint; SQL; and Tableau, PowerBI, and/or similar dashboarding software.
+ 3+ years of experience in statistical analysis, analyzing and interpreting data, and communicating to multiple external and internal stakeholders.
**Preferred Qualifications**
+ Previous experience with Medicaid and/or Medicare managed care.
+ Excellent problem-solving skills.
+ Excellent organizational and time management skills.
**Education**
+ Master's degree or equivalent experience (6 years of relevant experience + high school diploma or GED).
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$46,988.00 - $122,400.00
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 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.
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We anticipate the application window for this opening will close on: 12/02/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.