Lead Director Quality Mgt

Company: CVS Pharmacy
Location: Chicago
Posted on: August 8, 2022

Job Description:

Job DescriptionContinuous quality improvement is more than a buzzword - it's how we meet customer needs and control costs. Through Quality Management professionals, we put industry-leading practices and principles to work in support of our quality objectives.Implements an all product quality management strategy that meets internal and external constituent expectations for demonstrating quality outcomes. Using innovation, integration, and information links the quality management activities to business goals. Health Care Quality Management includes, but is not limited to, QM Programs/Infrastructure, behavioral health QM, credentialing, delegation and regulatory accreditation support, clinical and service measurement and improvement and quality of care investigations.Act as an Advocate for, and support, the business by serving as a quality champion through measuring and monitoring the quality and effectiveness of the care and service provided to our members. Lead and Manage all aspects of quality programs and projects that enable Aetna to measure, monitor, and improve the quality of the care and service provided to its members. Consult and/or work cross functionally to influence and promote change in order to continually deliver quality service to our internal and external customers.Responsible for coordinating, leading, and managing multiple functional areas/units including full accountability for business/financial results related to following as appropriate: HEDIS reporting, quality of care, accreditation activities and/or member satisfaction.Assures compliance with all State and Federal quality regulations, Aetna quality standards, and National Committee for Quality Assurance (NCQA) standards.Ensures maintenance of accurate documentation for quality improvement activities such as HEDIS reporting, surveys, audits, peer reviews, etc.In conjunction with key business leaders, responsible for directing the activities of quality committees.Provides direction setting and leadership, with accountability for quality program(s), specialized audits, special reviews, projects and initiatives.Manage complex projects, people, and business priorities to achieve member satisfaction.Develops and implements quality improvement activities nationally and/or within an assigned region.Directs data collection for HEDIS and/or other quality reporting; identifies opportunities for improvement based on results.Influences all stakeholders to support key quality projects/programs to ensure positive solutions that deliver results.Consults with internal/external customers on solutions that impact Quality.Controls expenses while meeting operational, functional and service requirements.Recruits, develops, and motivates staff.Initiates and communicates a variety of personnel actions, including employment, termination, performance reviews, salary reviews, and disciplinary actions.Previous experience that reflects a proven track record or proficiency in the competencies noted.Demonstrated verbal/written communication and computer skills.Ability to work in a fast paced environment.Demonstrated ability to plan, organize, and execute multiple functional business objectives.Previous experience managing staff.5 to 7 years clinical and/or managed care experience in the healthcare industry and quality management.Required QualificationsBachelor's degree or equivalent experience. Masters degree in a related field: MBA, MPH, HSA or equivalent preferred.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred QualificationsRN licenseEducationCertified Professional in Health Quality (CPHQ) or other certification a plusMasters degree preferredBachelor's degree desired or equivalent work experience.Additional Information:Exceptional communications skills including ability to interact with a variety of external and internal audiences including senior management.Business OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors--- support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Keywords: CVS Pharmacy, Chicago , Lead Director Quality Mgt, Executive , Chicago, Illinois