Manager - Healthcare Quality Project Management

CVS Health is building a more connected, convenient, and compassionate health experience while prioritizing safety and quality. The Manager - Healthcare Quality Project Management leads complex accreditation, compliance, and quality improvement projects, coordinating stakeholders, managing readiness activities, and ensuring regulatory deliverables are completed on schedule.

Responsibilities:

• Lead NCQA Accreditation project management activities, including workplan development, milestone tracking, risk management, document collection, and stakeholder coordination
• Coordinate accreditation readiness activities across Quality Management, Medical Management, Provider Services, Member Services, Operations, Compliance, and other functional areas
• Establish governance structures, project timelines, status reporting, and executive-level communications for accreditation and regulatory initiatives
• Monitor accreditation standards and requirements and partner with business owners to ensure ongoing compliance
• Facilitate accreditation workgroups, steering committees, and readiness reviews to identify risks, barriers, and corrective actions
• Manage document repositories, evidence collection processes, policies, procedures, and supporting materials required for accreditation submissions and surveys
• Track and report accreditation readiness metrics, action plans, and remediation efforts to leadership
• Support state regulatory audits, quality program evaluations, and external review activities as assigned
• Partner with Quality leadership to ensure alignment between accreditation requirements and organizational quality strategy
• Lead post-survey action planning and continuous improvement initiatives resulting from accreditation and regulatory findings

Requirements:

• Minimum of 3 years' experience in Project Management with the ability to manage multiple projects simultaneously
• Strong leadership skills and proven ability to facilitate cross-functional teams
• Excellent written and verbal communication skills
• 5+ Years experience working in managed care
• Proficiency in Excel and other Microsoft software/tools
• Experience leading complex cross-functional projects using formal project management methodologies
• Experience managing regulatory, compliance, accreditation, or healthcare quality initiatives
• Knowledge of NCQA standards, accreditation processes, and healthcare quality improvement principles
• Demonstrated ability to coordinate multiple stakeholders and drive accountability for deliverables
• Experience supporting health plan accreditation, survey readiness, or regulatory compliance activities
• PMP, Lean, Six Sigma, or related project management certification
• Experience within Medicaid managed care and healthcare quality operations preferred
• Knowledge of HEDIS, Quality Management programs, population health, delegated oversight, and performance improvement initiatives
• Strong background in analyzing data
• Strong background in population health
• Bachelors degree preferred