Senior Quality Consultant
CVSHealth
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.
Position Summary
Quality check complex benefit information, including non-standard plan language into crisp, compliant, easy-to-understand plan language for self-funded plans. This includes analyzing, drafting, editing, and reviewing all legal and regulatory plan documentation (i.e., SPDs, plan amendments. SBCs and restates) for our self-funded plan customers.
Basic understanding of regulations, laws, and internal procedures impacting self-funded health plans with attention to ensuring the plan and company remain in compliance with federal and state law.
Successfully negotiate deadlines when appropriate; influences change/enhancement to business processes, policies, and system infrastructure to improve information quality, availability, and access.
Deliver high-quality documentation ensuring department standards are met with a focus on ensuring all errors in spelling, grammar, and formatting are corrected before the document is sent to the customer.
May participate in implementation of department projects as needed.
Other duties as assigned.
Required Qualifications
3-5 years of plan writing experience supporting self-funded or fully insured plans.
Proficiency with Microsoft Office Word, Excel, SharePoint and Outlook applications.
Preferred Qualifications
Adept at problem solving and decision making skills.
Quality Improvement Associate Certification (CQIA).
Interpersonal skills to include written and verbal communication, critical thinking, persuasiveness, advising and counseling skills.
Ability to anticipate workload needs and to follow through with minimum direction.
Effective time management, organizational and prioritization skills.
Strong attention to detail and accuracy performing at high levels in a fast paced and constantly changing work environment.
Education
Associates degree or High School Diploma and equivalent work experience.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$18.50 - $42.35This 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.