Quality Practice Liaison (Must be licensed in Arizona or Multi-State)

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.

About the role

This is a full-time Quality Practice Liaison opportunity with the Arizona Mercy Care Plan. The working schedule is Monday-Friday during normal business hours. This is a typical office working environment with productivity and quality expectations. The Quality Practice Liaison position is a work-at-home role.

This person must be comfortable presenting HEDIS® gaps in care data to provider groups, including HEDIS® (Healthcare Effectiveness Data and Information Set) measure education and best practice information. The role involves obtaining, reviewing, abstracting, and data entering medical records utilized for HEDIS® supplemental data processes. The Quality Practice Liaison must understand the NCQA (National Committee for Quality Assurance) HEDIS® technical specifications for the designated HEDIS® supplemental data measures and apply this understanding to review, abstract, and data enter supplemental data.

Collaboration with the health plan HEDIS® project managers and other health plan departments (such as member services, provider relations, and integrated care management) is required to achieve the common goal of improving member outcomes, as measured by the HEDIS®/STAR measures. The role requires comfort accessing a variety of EMR systems remotely to obtain and abstract medical record data per specifications. Telework requires self-motivation and proactivity, with volume and accuracy expectations communicated and expected to be met.

Work requires the ability to read and interpret medical record documentation, both computer-generated and handwritten, as well as sitting at a workstation for extended periods of time typing on the computer.

Responsibilities

• Generates and distributes gap in care reporting from Tableau Dashboard.
• Actions outreach, scheduling meetings, developing presentations, and conducting meetings with provider groups to share HEDIS information.
• Reviews documentation and abstracts compliant medical record data for entry into supplemental data tool.
• Contacts the providers of record, vendors, or internal Aetna departments to obtain additional information as needed.
• Commands a comprehensive knowledge of NCQA HEDIS and STARS Measures for both Medicare and Medicaid.
• Works with a variety of electronic tools to accomplish team goals.
• Performs other duties as needed.

Requirements

• Active and unrestricted Arizona or compact state RN (Registered Nurse) license.
• 3+ years of clinical experience as an RN.
• 2+ years of experience with HEDIS quality measures.
• 1+ years of experience with delivering presentations.
• Demonstrated proficiency with technology, keyboarding, and various systems, including Microsoft Outlook, Teams, Word, Excel, PowerPoint, Adobe Acrobat, Windows 10, and QuickBase.
• Willingness to travel in the state of Arizona up to 10% of time, if commutable.

Preferred Qualifications

• High level of accuracy and attention to detail.
• Self-motivated and comfortable working under tight deadlines.
• Professional customer service demeanor, good work ethic, and ability to self-motivate.
• Conscientious problem solver, with a demonstrated willingness to learn.
• Proven organizational and time management skills.
• Excellent verbal & written communication skills, with a focus on clear, concise, and appropriate language.
• Experience with a variety of EMR (Electronic Medical Records) systems.
• Ability to multi-task, prioritize, and effectively adapt to a fast-paced, changing environment.
• Experience reading and interpreting medical records, including handwritten records.

Education

Associate Degree in Nursing.

Pay

The typical pay range for this role is $54,095.00 - $155,538.00 annually. This pay range represents the 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.

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. Benefits include:

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Schedule

• Full-time, 40 anticipated weekly hours.
• Monday-Friday during normal business hours.