Job Description:
• Establish and maintain engagement with large provider groups with membership of 1,000 or greater
• Analyze provider performance metrics and clinical operations for value-based care readiness and risk assessment
• Identify improvement areas and develop data-driven strategies to improve provider performance and financial rewards
• Assess practice operations against primary-care industry best practices
• Design and deliver training programs, workshops, and educational materials for providers and staff
• Facilitate sessions on clinic operations, quality standards, regulatory compliance, member experience, and patient-centered care
• Lead performance improvement initiatives and implement performance improvement plans
• Monitor progress and evaluate intervention effectiveness with practice partners
• Conduct audits, reviews, and assessments of provider practices, documentation, and compliance
• Provide feedback and recommendations for improvement
• Collaborate with clinical and operational leadership, value-based care, quality management, and provider relations teams
• Foster working relationships with providers and provide guidance, feedback, and support
• Use data management systems and analytics tools to collect, analyze, and report provider performance data
• Prepare reports, dashboards, and presentations for senior leadership
• Monitor industry trends, best practices, and regulatory changes related to provider performance and healthcare quality
• Support population health and health equity initiatives
• Conduct research and benchmarking to identify innovative improvement opportunities
• Work remotely with up to 30% regional travel
Requirements:
• 5–7 years of experience in healthcare quality improvement, provider relations, or a related role
• In-depth knowledge of healthcare regulations, clinical operations, quality standards, and performance metrics
• Strong analytical and problem-solving skills with ability to interpret complex data sets
• Excellent communication, presentation, and interpersonal skills
• Experience 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
• Remote-work capability with a secure home network
• Familiarity with Microsoft Office products and VPN
• Ability to travel regionally up to 30%
• Bachelor's degree or commensurate work experience in healthcare administration, public health, or a related field
• Preferred: Licensed Allied Health Professional or Licensed Registered Nurse
• Preferred: Coding, provider-facing, clinical, or provider practice experience
• Preferred: Certified Six Sigma Green Belt
• Preferred: Certified Professional in Healthcare Quality (CPHQ) or equivalent
Benefits:
• CVS Health bonus, commission or short-term incentive program in addition to the base pay range
• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources supporting the physical, emotional, and financial well-being of colleagues and their families, based on eligibility