Senior Quality Specialist, CVS Health

Senior Quality Specialist

CVS Health

Location:
United States

Category:
Quality Control

Contract Type:
Not provided

Salary:

18.50 - 42.35 USD / Hour

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Job Description:

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.

Job Responsibility:

Acts as an advocate and subject matter expert guiding the business
Serves as a quality champion through measuring and monitoring the quality and effectiveness of work processes in claim processing and customer service
Consults cross-functionally with other departments to influence and promote change
Performs regular quality audits for service operations for multiple products and platforms
Executes both routine and non-routine business support tasks
Conducts standard quality reviews and audits
Owns responsibility for supporting targeted quality audit projects

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
Claims experience
DG experience

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
Wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
September 12, 2025

Expiration:
September 19, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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