Senior Analyst, Health Care Quality Management - HEDIS (Remote)

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

Subject Matter Expert in HEDIS improvement work; may interact with providers, stakeholders and members to facilitate actions that improve healthcare outcomes such as increased preventive care compliance.Key Responsibilities

• Takes a leadership role in the development and implementation of quality management projects and activities.
• Partner cross functionally to deliver tools supporting the HEDIS team.
• Communicate with stakeholders on key HEDIS activities.
• Conducts outreach with complex provider partners to share information to improve health outcomes.
• Delivers Quality information to internal and external constituents via written and verbal communication.
• May support training of new quality management staff regarding program description, work plan and evaluation activities.
• Actively seeks opportunities for process improvement resulting in efficient and effective work streams.
• Supports more complex relationships with both internal and external constituents.
• Consults with constituents on solutions to business issues including education and process improvement opportunities.
• Support complex provider partners with HEDIS gaps in care, data feed, and remote medical record collection discussions and education.
• Independently conduct measure research and datamining throughout the year.

Required Qualifications:

• Strong verbal and written communication skills.
• Provider engagement and/or liaison experience.
• 5+ years recent and related health care experience in any setting.
• 5+ years HEDIS measure knowledge.
• 3+ years of Medicare experience.
• 5+ years of HEDIS medical record abstraction experience.
• Ability to use standard corporate software packages and corporate applications.
• Ability to work independently.
• Flexible/ability to quickly shift priorities.

Preferred Qualifications:

• Project Management Experience or Certification 3+ years.
• Experience speaking with medical providers and/or medical office staff.
• Health insurance experience.
• Understanding of CPT/CPTII/ICD9/ICD10 coding and medical terminology.

Education

• Bachelors Degree or equivalent experience.

Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$46,988.00 - $91,800.00This 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: 12/23/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Summersville, WV

Job ID: CVS-R0788804

Employment Type: FULL_TIME

Posted: 2025-12-21T19:34:23