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Quality & Compliance, Quality Management Nurse Consultant

Yesterday Springfield, IL

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 SummaryThis role is responsible for managing partnerships with Aetna-Illinois quality vendors and community-based organizations, with the primary focus to improve HEDIS and CAHPS measure performance. This includes analysis of vendor effectiveness, management of vendor / partner lead transmission, oversight of vendor performance reporting strategy, a risk reporting process, leading and managing joint operating committee meetings and project workplans in alignment with vendor contracts and SLAs.This role is also responsible for developing and implementing a comprehensive incentives and rewards strategy for members, supported by a robust monitoring and governance structure to assess understanding and effectiveness. The strategy includes developing key performance indicators to assess the effectiveness and desired outcomes of the member incentives and rewards program, while providing monthly reporting to committees and other agencies. Without this role, these activities would be divided among team members without having the consistency and focus that this role provides.Required Qualifications- 3 years Vendor Contracting and Performance Management

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- 3 years Managed Care and/or Healthcare Quality Experience

- 2 years Project Management

- 1year experience Member facing or member program

- Clinical license required

Preferred Qualifications- 2 years HEDIS experience

- MBA or masters degree in healthcare or finance related fieldEducationBachelor's degree in nursing or health related field Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$66,575.00 - $142,576.00This 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 peopleWe 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/benefitsWe anticipate the application window for this opening will close on: 09/05/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Springfield, IL
Job ID: CVS-R0676069
Employment Type: OTHER
Posted: 2025-08-17T19:37:02

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • HSA
    • HSA With Employer Contribution
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Fertility Benefits
    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Office Life and Perks

    • Vacation and Time Off

      • Paid Vacation
      • Paid Holidays
      • Personal/Sick Days
    • Financial and Retirement

      • 401(K) With Company Matching
    • Professional Development

      • Tuition Reimbursement
    • Diversity and Inclusion

      • Employee Resource Groups (ERG)
      • Diversity, Equity, and Inclusion Program