Senior Analyst, Health Care Quality Management

CVS Health

. Accountable for Commercial, Medicare, Exchange and Medicaid NCQA Accreditation quality projects and initiatives through design, development, and implementation .

Posted 9/21/2026full-timeRemote • California • United StatesSenior💰 $46,988 - $112,200 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in NCQA Accreditation standards and quality management principles, with a strong focus on delegated credentialing and compliance monitoring. Proficient in data analysis and visualization to drive quality improvement initiatives in the healthcare industry.

Highest-signal resume keywords

NCQA Accreditation ExpertiseDelegated Credentialing OversightStatistical Analysis and Data VisualizationQuality Management and ComplianceStrong Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Statistical AnalysisData VisualizationCredentialingAuditingPerformance Metrics DevelopmentQuality ImprovementDatabase QueriesMS ExcelMS WordAdobe Acrobat

Soft Skills

Problem SolvingDecision MakingRelationship BuildingCommunication

Industry Keywords

Healthcare IndustryQuality ManagementCompliance StandardsPatient SafetyClinical EffectivenessPatient ExperienceHICE CollaborativeAccreditation ReadinessCross-Functional CollaborationTraining Program Development

About the role

Key responsibilities & impact

Accountable for Commercial, Medicare, Exchange and Medicaid NCQA Accreditation quality projects and initiatives through design, development, and implementation
Focus primarily on Delegated Credentialing and Oversight of delegated Credentialing organizations, per contract
Build strong business relationships with internal and external business partners
Present accreditation requirements to business partners to achieve results and ensure accreditation readiness
Serve as a subject matter expert on NCQA accreditation standards, analysis, delegated credentialing file reviews and supporting quality functions
Utilize statistical analysis, data visualization tools, and database queries to identify trends, patterns, and opportunities for quality improvement
Develop and maintain performance metrics and dashboards covering patient safety, clinical effectiveness, patient experience, and compliance with quality standards
Contribute data-driven insights and recommendations to quality improvement projects and initiatives
Collaborate with cross-functional teams to design and implement evidence-based practices, care protocols, and process improvements
Assist with audits and chart reviews to monitor compliance with regulatory requirements and quality standards
Prepare reports and presentations on quality metrics, performance trends, and improvement initiatives
Communicate findings transparently to leadership, providers, stakeholders, and relevant teams
Integrate new quality improvement efforts and facilitate resolution of care coordination issues
Assist in developing and delivering training programs on quality management principles, best practices, and data visualization tools
Conduct annual oversight of delegated entities, including auditing, corresponding with delegates, and working with the HICE collaborative to pull down audits
Interact with Aetna Network Departments and delegated entities
Complete ongoing monitoring of corrective actions
Attend HICE Collaborative policy and scheduling meetings

Requirements

What you’ll need

Working knowledge of problem solving and decision making skills
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
Credentialing experience
High School Diploma or General Equivalent Development (GED), required
NCQA experience, preferred
Auditing Experience, preferred
College Education, preferred
40 anticipated weekly hours

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