Accountable for Medicaid NCQA accreditation quality projects and initiatives through design, development and implementation. Assimilates information to proactively develop quality activities aligned with company strategies and values. Links the quality management activities to business goals. Proactively builds strong business relationships, both internally and externally. Serves as a resource and subject matter expert on all aspects of the quality program to develop and influence business strategies.
Makes business decisions based on the results of research and data analysis. Proven experience as a subject matter expert on NCQA accreditation standards, analysis, file reviews and supporting quality functions. Collaborates in the design, development, and implementation strategy of quality improvement projects and initiatives supporting accreditation. Forms and leads cross functional teams to assist business units in integrating quality activities. Manages, directs and plans multiple complex accreditation projects through completion of business objectives. Design and develop templates, materials and guidance documentation. Influences change or enhancements to policies and processes to improve information quality, availability and access. Develops and participates in presentation and consulting to business partners on accreditation requirements, activities and results. Works cross-functionally to achieve business excellence.
4-6 years managing NCQA accreditation activities through multiple cycles. Progressive experience in operational quality management roles in the healthcare industry, regulatory environment and quality management. Demonstrated leadership ability. Data interpretation and analysis experience. Excellent verbal and written communications skills. Demonstrated ability to effectively coordinate multiple projects simultaneously.
3-5 years experience leading staff
Experience with Medicaid health plans preferred.
Bachelor's degree or other comparable healthcare experience.
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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