Sr Mgr, Health Care Qual Mgt

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary Leads and oversees the Population Health Program by setting strategic goals and driving initiatives to improve patient outcomes and safety. Collaborates with clinical staff, administrators, and other stakeholders to develop and implement coordination and oversight of the Population Health Management program and services that support defined populations across the care continuum, promoting healthy behaviors and targeted inventions for those identified at risk or who have chronic conditions. Analyzes healthcare data, identifies trends and areas for improvement, and ensures compliance with quality standards and regulations. What You Will Do • Directs the development and implementation of an integrated PHM Program that incorporates components of NCQA’s PHM Program as well as ensures to assess, monitor, and continuously improve the quality of healthcare services, processes, and outcomes. • Oversees plan efforts oversees plan efforts to support Enrollees to maintain or improve physical health and behavioral health and to consider and address functional needs and SDoH. • Directs innovative population health programs and services across the care continuum, promoting healthy behaviors and self-management supported by evidence-based medicine and national best practices • Establishes processes to evaluate population health and healthcare quality and identify areas for improvement, analyzing data related to patient outcomes, customer satisfaction, and operational efficiency to drive quality improvements. • Delivers initiatives to improve population health processes and workflows, collaborating with cross-functional teams to identify inefficiencies, streamline processes, and enhance the overall quality of care. • Participates in the development of healthcare quality policies and procedures, staying up-to-date in industry best practices and regulatory changes. • Liaises with external organizations, regulators, and accreditation bodies to develop relationships and open communication channels that facilitate the resolution of compliance-based issues. • Collaborates with cross-functional teams to identify areas for improvement, develop action plans, and implement evidence-based practices to enhance patient care, safety, and outcomes. • Establishes population health related stakeholder engagement strategies, including those for Enrollees, Providers, community resources, and social services agencies. • Creates and delivers training programs to educate staff on population health and quality management principles, best practices, and compliance requirements. • Hires and follows the performance of project managers, providing guidance, support, and mentorship to improve departmental capabilities. Required Qualifications • 7-10 years work experience in public health, population health management, clinical management, or related field. • Adept at operationalizing NCQA Accreditation, Population Health Management Standards. • Adept at execution and delivery (planning, delivering, and supporting) skills • Adept at business intelligence • Adept at collaboration and teamwork Preferred Qualifications • Mastery of problem solving and decision making skills • Mastery of growth mindset (agility and developing yourself and others) skills Education • Bachelor's degree preferred with specialized training/relevant professional qualification. Pay Range The Typical Pay Range For This Role Is $67,900.00 - $149,328.00 This 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. This position also includes an award target in the company’s equity award program. 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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit We anticipate the application window for this opening will close on: 09/28/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Apply tot his job