Quality Practice Transformation Advisor, CVS Health

CVS Health

Location:
United States, Work At Home

Category:
Health and Beauty

Contract Type:
Not provided

Salary:

60300.00 - 132600.00 USD / Year

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Job Description:

The Quality Practice Transformation Advisor plays a critical role in supporting the highest standards of practice performance and quality within our organization's network of healthcare providers. The primary focus is to 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

Job Responsibility:

Provider Engagement: Establish and maintain engagement with large provider groups that have a membership of 1,000 or greater
Performance Analysis: Conduct comprehensive analysis of provider performance metrics as well as clinical operations for VBC readiness and risk assessment
Provider Education and Practice Transformation: Collaborate with cross-functional teams to assess practice operations against industry best practices in primary care
Performance Improvement Initiatives: Lead initiatives aimed at improving provider performance
Quality Assurance: Conduct regular audits, reviews, and assessments of provider practices, documentation and compliance
Stakeholder Collaboration: Collaborate closely with internal teams, including clinical and operational leadership, value-based care, quality management teams and provider relations teams to align provider performance objectives with organizational goals
Data Management and Reporting: Utilize data management systems and analytics tools to collect, analyze, and report provider performance data
Industry Knowledge and Research: Stay abreast of industry trends, best practices, and regulatory changes related to provider performance and healthcare quality

Requirements:

5+ years of experience in healthcare quality improvement, provider relations, or a related role
2+ years Process Improvement experience related to HEDIS measures
In-depth knowledge of healthcare regulations, clinical operations, quality standards, and performance metrics
Medicaid experience
Strong analytical and problem-solving skills, with the ability to interpret complex data sets and identify improvement opportunities
Excellent communication, presentation and interpersonal skills to collaborate with and effectively influence provider groups and executives, team members, and stakeholders at all levels
Proven experience in designing and delivering training programs or educational initiatives
Proficiency in data management and analysis tools, such as Excel or data visualization software
Familiarity with electronic health record systems and healthcare information technology
Detail-oriented, organized, and able to manage multiple projects simultaneously
Ability to work independently, demonstrate initiative, and drive results in a fast-paced environment
Position is remote – secure home network required and familiar with Microsoft Office products and VPN

Nice to have:

Licensed Allied Health Professional or Licensed Registered Nurse
Coding or Sales background
Certified Six Sigma Green Belt
Certified Professional in Healthcare Quality (CPHQ) or equivalent
Certified NCQA PCMH Content Expert

What we offer:

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

Additional Information:

Job Posted:
August 02, 2025

Expiration:
August 31, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Quality Practice Transformation Advisor