Senior Manager Health Care Quality

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
Supportive of MI State Contract deliverables, QAPI Program and regulatory standards. Processes and evaluates complex data and information sets in the development of strategic solutions to business issues and initiatives through direction setting and project management work. Responsibilities include assimilating information to proactively develop quality activities aligned with program goals and objectives; linking the quality management activities to business goals; advance business objectives by supporting and connecting diverse teams, fostering productive partner relationships, and applying deep quality expertise to help teams translate quality insights into business strategy.

• Works with Director of Quality to assist in making business decisions based on the results of research and data analysis
• Leads cross functional teams to assist the health plan departments in integrating quality into their strategic and operational plan
• Evaluates and prioritizes recommendations for quality improvement to senior health plan Management
• Helps to evaluate the Plans HEDIS Strategy and makes recommendation for improvement in closing gaps in care, to achieve NCQA HEDIS metric benchmarks
• Helps to develop strategy and improve Auto Assignment Algorithm (AAA) band ranking performance
• Helps to develop and improve CAHPS Member Satisfaction Survey scores/outcomes
• In partnership with functional areas and business owners, works to improve Michigan specific Apple Consumer Guide scores
• Helps to develop and implement improvement strategy for NCQA Star rating
• Works to help facilitate and improve Quality Withhold metrics, as defined by the State on an annual frequency
• Works with Plans Dental Vender to improve Dental Program Strategy and performance outcomes to align with State and National benchmarks
• Develops and implements the infrastructure of the QM program and patient safety strategy and PQOC analysis/issues
• Directs/provides enhancements to business processes, policies, and infrastructure to improve operational efficiency across the organization
• Influences department business owners and leaders to reach solutions to meet the needs of stakeholders, internal and external
• Provides comprehensive analysis of state PIP's, barriers, and opportunities and presents results of improvement efforts and ongoing performance measures to plan management
• Promotes strategy to improve Michigan 'Apple Ratings' and scores through improved HEDIS, CAHPs and metric performance

• 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.