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COMPLETE Healthcare Quality Manager - Must live in New York City, NY - NY - New York

3 days ago


Job Opportunity Details


Full Time


Not Telling

Work from home


Weekly Working Hours

Not Telling


Not Telling

Working Location

New York-161 Ave of the Americas, NY - New York, United States   [ View map ]

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

The Manager Health Care Quality Management will manage the launch and ongoing quality related functions of the New York duals Fully-Integrated Dual Eligible (FIDE) quality program. These functions include regulatory deliverables, HEDIS activities and reporting and other quality improvement activities. Provide support to staff and communicate with departments across the health plan to facilitate daily quality improvement (QI) functions. Coordinate and monitor quality improvement and organizational projects from inception to closure including Healthcare Effectiveness Data and Information Set (HEDIS) and Uniform Assessment System (UAS) measures. Manage federal and state assigned quality improvement projects and be an active participant in external facing meetings with state of NY. Coordinate Work Plan, team and resources for all QI activities. Monitor all workplan activities to ensure both state and federal compliance. Write the annual quality program documents (program description, workplan, program evaluation) and manage activities throughout the year. Ensure all quality policies are updated annually and in compliance with state contract. Collaborate with all internal and external stakeholders in identifying, developing, and implementing innovative programs and initiatives to improve outcomes. Analyze data, develop reports and present to plan committees. Design, run, and manage the data review process to ensure accuracy and integrity of data reports to meet regulatory and operational requirements. Coordinate and implement interventions to increase HEDIS, CAHPS, and UAS measure improvement projects. Adhere to NCQA standards and work with National Quality Management Accreditation team to obtain and maintain the plan's NCQA accreditation. Support the coordination of corporate compliance and external surveys as needed. Support the project life cycle including requirements gathering, creation of project plans and schedules, manage resources, support HEDIS audit process, and facilitate project execution, deployment and closure. Coordinate data pulls and ongoing data management for HEDIS and QI project management databases for identified QI projects with department staff and corporate contacts. Evaluate sources for alternative data capture; assess ongoing methodology and results.

Working with internal partners to launch and continue to execute the Quality programs for the new New York FIDE plan, which will have members in Brooklyn.  We are a small Quality team, with one person devoted to each state, so there are others on the team from whom this person can get guidance, but most execution will be the responsibility will rest with this person.  Be the “face of Quality” externally to the State of New York for the NY FIDE program.

Required Qualifications

  • Must live in New York City, NY
  • Must be willing to travel around NY
  • 5-7 years of managed care experience with quality programs
  • 1-3 years of Project Management and leadership experience
  • Good written and verbal communication
  • Analytical experience/understanding
  • Project management and leadership experience.

Preferred Qualifications

  • Clinical experience or similar
  • Proficient in Excel, Word, and PowerPoint for date analysis and reporting


Bachelor's Degree, Nursing degree, or other equivalent healthcare experience

Pay Range

The typical pay range for this role is:

$69,300.00 - $149,600.00

This 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. 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. 

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution. 

More Information

Application Details

  • Organization Details
    4004 Aetna Medicaid Administrators

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