CVS Health Job - 35208303 | CareerArc
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Company: CVS Health
Location: PA
Career Level: Mid-Senior Level
Industries: Retail, Wholesale, Apparel


Job Description
Aetna Better Health of PA is hiring two Quality Management (QM) Project Managers with a background in quality or dental professional to support our Medicaid Health Plan.
These two positions are Work From Home - Full Time, with the preference that the employee reside in Pennsylvania to cover the specific assigned territories (Southeast, Southwest, Northwest, Lehigh/Capital and Northeast)
Territories will be assigned based on a candidate's home location and business need. Initially, this position will involve meeting remotely with the provider offices during the course of the COVID pandemic, transitioning to be in the field if candidate is located in Pennsylvania. Reliable transportation and current driver's license are required.
Our QM Project Managers will have the ability to successfully manage a number of providers and provide both remote and in-person education to providers on HEDIS and state measures to increase the appropriate access of care for our members, and optimize the capture of that care that will be reflected in increased HEDIS rates.


Fundamental Components

  • Conduct remote and onsite visits to  provider offices in Pennsylvania to provide education on closing gaps that lead to improved HEDIS rates focusing on preventive and conditions specific care
  • Provides an opportunity to manage daily schedule to meet established HEDIS goals
  • Excellent opportunity to influence practices that result in improved outcomes for members with Medicaid insurance
  • While part of a robust Quality Management team, the candidate will have the ability to work independently with the full support of peers and management

Background Experience
  • 2-4 years experience in Dental or managed care quality management
  • Project management experience preferred
  • HEDIS and/or coding knowledge specific to Dental strongly preferred
  • Experience working with provider offices, including Dental preferred
  • Excellent oral and written skills
  • Experience with data - gathering, interpretation, and meaningful analysis


Bachelor's degree or equivalent experience

Percent of Travel Required
75 - 100%

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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