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

Conduct onsite visits with Virginia provider groups, deliver gap in care reports and work with provider offices to get members scheduled and close gaps, streamline/simplify by providing direct communication between providers and Quality. Identify areas for quality improvement, partner with provider practices to implement quality strategies that improve quality and cost of care, member, and clinician experience, and drive positive outcomes in the delivery of patient care. Providers will have direct access to speaking with expert with the ability to explain details around performance measures, their current performance rates, and provide resources to improve performance. Additional responsibilities include abstracting medical records year-round.

Required Qualifications

3+ years of experience with Managed Care - direct patient care, social work, quality improvement or health coaching, preferably in a managed care environment

3+ years HEDIS or NCQA experience

Must possess reliable transportation and be willing and able to travel up to 20% of the time. Mileage is reimbursed per our company expense reimbursement policy

Preferred Qualifications

One of the following license/certifications: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CBCS

Experience with Coding

Experience with provider facing activities/Value Based Care/Network

Education

Bachelor’s Degree Required

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$46,988.00 - $102,000.00

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. 
 

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 people

We 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/benefits

We anticipate the application window for this opening will close on: 08/01/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.