Informatics Manager - Quality - HEDIS

Position Summary

Leverages technology and data to improve healthcare outcomes by designing, implementing, and maintaining health information systems, analyzing healthcare data, and utilizing technology to support clinical workflows and decision-making. Applies expertise in healthcare and information technology to ensure efficient data management, promote data-driven insights, and enhance the delivery of healthcare services.

What You Will Do

• Ensure regulatory, audit, and compliance readiness for HEDIS and State reporting
• Advance governed AI–enabled change control aligned to NCQA, CMS, and state requirements—improving consistency and cycle time with maintained accountability
• Assesses the requirements of the informatics department and identifies integration opportunities for new technologies and system processes
• Assists the informatics team in the management of the data, reporting, and analytics function to help internal teams draw meaningful conclusions
• Coaches the informatics team on how to apply statistical and computational methods to analyze research data
• Conducts thorough literature reviews to understand the current state of knowledge data management, information systems, machine learning, and artificial intelligence
• Confers with industry partners on ways to apply research findings to real-world settings to advance industry knowledge
• Designs a documentation system for the informatics system to outline system specifications, architectural diagrams, and user guides
• Determines best approaches to define data models, data integration processes, and data governance policies for the informatics department
• Develops complex data migration systems to coordinate with data management teams to ensure accuracy in transferring information into new informatics systems
• Establishes a testing system for the informatics department to ensure defined requirements and functions are met

Required Qualifications

• 3+ years relevant work or equivalent experience
• Adept at SQL and/or Python
• Adept at Business Intelligence reporting (Tableau, Power BI, etc.)
• Adept at problem solving and decision-making skills
• Adept at collaboration and teamwork
• Adept at growth mindset (agility and developing yourself and others) skills
• Adept at execution and delivery (planning, delivering, and supporting) skills
• Ability to translate non-analytical customer needs into analysis and reporting and communicate data insights

Preferred Qualifications

• Experience working in Healthcare Quality Management
• Experience with NCQA HEDIS and other quality metrics
• Experience with AI-facilitated reporting with disciplined governance and oversight
• Preferred education in Statistics, Mathematics, Data Analytics, or related STEM field

Education

Bachelor's degree or equivalent work experience

Pay

The typical pay range for this role is $54,300.00 - $145,860.00. 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.

Schedule

Anticipated Weekly Hours: 40. Time Type: Full time.

Benefits

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.