• Job Description

  Req#: R0611229

  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

  Ensures the delivery of evidence-based care and services for members according to HFS quality strategy and ABHIL population health model. The Quality Management, Nurse Consultant directs analysis and reporting of member and provider data to monitor interventions and effectiveness.

  Additional responsibilities to include but not limited to the following:

  - Plans, conducts and evaluates targeted member/provider initiatives and supports the development of HEDIS interventions and initiatives within the Quality Management Team.

  - Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with HEDIS, regulatory, and accreditation requirements for member and/or provider issues.

  - Works closely with the Quality team, leadership and POSC to drive population-based improvements in care and outcomes.

  
  
  Required Qualifications

  - 5 years experience in managed care, clinical, or health care related field.

  - 1 year of project management experience.

  - Registered Nurse (RN) license in the state of their residence.

  
  Education

  
  Bachelors Degree required

  Anticipated Weekly Hours

  40

  Time Type

  Full time

  Pay Range

  The typical pay range for this role is:

  $66,575.00 - $142,576.00

  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.
  

  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 https://jobs.cvshealth.com/us/en/benefits

  We anticipate the application window for this opening will close on: 07/18/2025

  Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

• About the company

  At CVS Health, we share a clear purpose: helping people on their path to better health. Through our health services, plans and community pharmacists, we’re pioneering a bold new approach to total health. Making quality care more affordable, accessible, simple and seamless, to not only help people get well, but help them stay well in body, mind and spirit.

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