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CVS Health · 1 day ago

Senior Manager, Quality Care - Aetna Mercy Care AZ - RN

Arizona, United States

Full-time

Hybrid

Mid, Senior Level

$100K/yr - $216K/yr

7+ years exp

CVS Health is a leading health solutions company dedicated to transforming health care. The Senior Manager, Quality of Care is responsible for leading quality assurance activities across healthcare operations, ensuring compliance with regulatory standards and fostering a culture of safety and excellence.

Health CareMedicalPharmaceuticalRetailSales

Responsibilities

Quality of Care Investigations: Lead and manage investigations into care concerns, ensuring timely resolution, thorough documentation, and implementation of corrective actions

Seclusion and Restraint Oversight: Monitor and evaluate the use of seclusion and restraints, ensuring compliance with clinical guidelines and safety protocols. Prepare and present monthly and quarterly reports to the Quality Committee

Staff Management: Supervise and support quality and safety staff, fostering a culture of accountability, continuous improvement, and professional development

After-Hours On-Call Response: Serve as the primary on-call contact for urgent health and safety issues, including Immediate Jeopardy (IJ) situations, ensuring rapid response and coordination with internal and external stakeholders

Mortality Committee Leadership: Facilitate and lead mortality review meetings, analyze trends, and drive system-level improvements based on findings

Peer Review Support: Collaborate with clinical leadership to assist in peer review case preparation and follow-up, ensuring fairness, transparency, and adherence to policy

Quality Committee Participation: Actively contribute to the organization’s Quality Committee by presenting findings, updates, and strategic recommendations to enhance care outcomes

Data Analysis & Reporting: Compile, analyze, and interpret clinical and operational data to identify trends, support decision-making, and inform quality improvement initiatives. Develop and deliver reports and presentations for internal stakeholders and committees

Qualification

Arizona RN licenseHealthcare quality managementClinical leadership experienceData analysisMicrosoft Office SuiteMedicaid populationsQuickBaseStaff management

Required

Arizona resident

Active and unrestricted Arizona RN license

Minimum 7 years of clinical experience

At least 3 years of experience in healthcare quality management

Minimum 3 years of clinical leadership experience, including direct staff management

Demonstrated experience in data analysis and reporting, with strong ability to extract, interpret, and present data

High proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Teams)

Ability to travel up to 10% in state for leadership meetings in Phoenix or visits to facilities as needed for assistance with incidents

Ability to participate in on-call rotation

Preferred

Experience working with Medicaid populations

Familiarity with QuickBase or similar data management platforms

Benefits

Affordable medical plan options

401(k) plan (including matching company contributions)

Employee stock purchase plan

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching

Paid time off

Flexible work schedules

Family leave

Dependent care resources

Colleague assistance programs

Tuition assistance

Retiree medical access