Analyst, Health Care Quality Management

CVS Health Careers

. Conduct oversight audits of delegated entities contracted to perform credentialing functions on behalf of Aetna .

Posted 11/12/2026full-timeRemote • Illinois • United StatesMid-LevelSenior💰 $43,888 - $93,574 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in delegated credentialing and quality management within the healthcare industry, ensuring compliance with NCQA standards and regulatory requirements while effectively managing multiple priorities and maintaining detailed documentation.

Highest-signal resume keywords

Delegated Credentialing ExperienceQuality Management Strategy ImplementationNCQA Compliance EvaluationData Analysis SkillsStrong Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Credentialing FunctionsQuality Management Work PlansProcess Compliance EvaluationCorrective Action Plans DevelopmentQuantitative Data AnalysisQualitative Data AnalysisDocument PreparationOperational Workflow EvaluationRegulatory ComplianceAccreditation Readiness

Soft Skills

Attention to DetailOrganizational AbilitiesAdaptabilityDocumentation SkillsClient Communication

Tools & Technologies

MS ExcelMS WordAdobe Acrobat

Industry Keywords

Healthcare IndustryNCQA StandardsFederal RegulationsState RegulationsContractual Requirements

About the role

Key responsibilities & impact

Conduct oversight audits of delegated entities contracted to perform credentialing functions on behalf of Aetna
Implement an all-product quality management strategy
Participate in development and ongoing implementation of Quality Management work plans and activities
Evaluate process compliance and operational workflows for delegated credentialing functions
Evaluate adherence to NCQA standards, applicable federal and state regulations, and contractual requirements
Review and validate delegate-submitted reports, logs, and supporting materials
Ensure compliance and maintain readiness for NCQA accreditation
Develop and track corrective action plans
Assist in QM projects and activities
Document QM activities to demonstrate compliance with business, regulatory, and accreditation requirements
Perform quantitative and qualitative data analysis to achieve operational targets
Prepare QM documents
Report business information to internal and external constituents and consult on solutions for emergent issues

Requirements

What you’ll need

Minimum of 2 years of delegated credentialing experience within 2–5 years of overall credentialing experience (preferred)
3+ years work related experience in the healthcare industry or quality management
Strong computer skills including mastery of MS Excel, Word and Adobe Acrobat
Strong communication skills with external clients, primarily delegate entity contacts
Strong attention to detail, organizational abilities, and excellent documentation skills (preferred)
Ability to manage multiple priorities and adapt to changing demands (preferred)

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
CVS Health bonus, commission or short-term incentive program in addition to base pay