Quality Management Nurse Consultant (QMNC) - Remote

Overview

As a Quality Management Nurse Consultant at CVS Health, you will play a crucial role in supporting clinical compliance audits and improving healthcare outcomes through data analysis and collaboration with various teams.

In Short

• Conduct clinical compliance audits and investigations.
• Provide training and education on compliance-related topics.
• Analyze data to identify trends and recommend improvements.
• Monitor adherence to clinical policies and regulatory standards.
• Collaborate with cross-functional teams to meet compliance objectives.
• Condense complex information into actionable insights.
• Gather data from multiple systems for audits.
• Communicate findings to ensure follow-up actions.
• Work independently and as part of a team.
• Utilize strong analytical and problem-solving skills.

Requirements

• RN licensure required.
• 3-5 years of Utilization Management clinical experience.
• Strong analytical skills and root cause analysis proficiency.
• Excellent communication skills for training and education.
• Ability to condense complex information clearly.
• Experience with compliance audits in healthcare.
• Familiarity with regulatory policies and accreditation guidelines.
• Bachelor's degree preferred.
• Proactive and creative problem-solving abilities.
• Attention to detail and collaborative mindset.

Benefits

• Affordable medical plan options.
• 401(k) plan with company matching.
• No-cost wellness programs.
• Paid time off and flexible work schedules.
• Tuition assistance and retiree medical access.
• Confidential counseling and financial coaching.
• Dependent care resources and family leave.
• Employee stock purchase plan.
• Comprehensive benefits for health and wellness.
• Opportunities for professional growth and development.