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Quality Specialist

AT CVS Health
CVS Health

Quality Specialist

Franklin, TN

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.

  • Description
    Supports the business by measuring and monitoring the quality and effectiveness of work processes in claim processing and/or customer service that impact customer satisfaction, medical cost management, and operational efficiency.Primary Job Duties & Responsibilities

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  • Communicates with quality specialists on established procedures to support business tasks for the quality assurance function.
  • Maintains effective relationships with departments and teams to ensure daily communication to resolve issues and prevent delays in service.
  • Defines the organizational standard for quality audits and reviews and instructs associates on how to measure compliance within established guidelines.
  • Assists in the data collection and analysis to identify trends in quality control outcomes.
  • Monitors internal teams and assists with the daily maintenance and operations of business units.
  • Observes team operations and identifies opportunities to maximize business output.
  • Operates within a team of quality specialists and takes direction from senior management on new initiatives.
  • Compiles periodic reports on quality metrics to identify patterns in quality issues.
  • Collects and compiles data across the organization to measure and analyze performance in various operations.
Required Qualifications:
  • 1 -2 years of working experience in auditing, quality review, or related insurance operations
Preferred Qualifications:
  • E xperience working with Medicare Supplement, Final Expense, or Ancillary insurance applications
  • St rong ability to follow documented processes and procedures
  • P revious experience creating reports used for monitoring quality performance, identifying error trends, and/or providing feedback for process improvement.
  • F amiliar with Microsoft products such as Excel, OneNote, Word, Outlook
Education:
  • High school diploma or up to 1 year equivalent experience.

Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$17.00 - $28.46This 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: 07/21/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Franklin, TN, USA
Job ID: CVS-R0643859
Employment Type: Other

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
  • 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