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CVS Health Logo CVS Health · Quality Control

Senior Quality Specialist

United States, Work at Home 18.50 - 38.82 USD / Hour · Job Posted May 28, 2026

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Job Description

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Job Responsibility

  • Acts as an advocate and subject matter expert guiding the business by serving as a quality champion through measuring and monitoring the quality and effectiveness of work processes in claim processing and customer service that impact customer satisfaction, medical cost management, and operational efficiency
  • Consults cross-functionally with other departments to influence and promote change, to continually deliver quality service to both internal and external customers
  • Performs regular quality audits for service operations for multiple products and platforms to drive full and consistent compliance to all required standards

Requirements

  • 2+ years of health insurance work experience and/or Healthcare Insurance Quality Review
  • 2+ years of experience working with diagnosis codes and medical terminology
  • Moderate to advanced knowledge of Excel (V-lookups, pivot tables, and/or formulas)
  • High School Diploma or equivalent GED

Nice to have

  • Working knowledge of problem solving and decision making skills
  • College degree preferred
  • Claims experience
  • DG system experience

What we offer

  • medical, dental, and vision coverage
  • paid time off
  • retirement savings options
  • wellness programs
  • CVS Health bonus, commission or short-term incentive program
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