About the job
Quality Improvement Specialist
Remote Employment – Alabama or Mississippi
Full-Time and Part-Time positions available
Who We Are:
Constellation Quality Health is a non-profit health care quality consultancy and QIO-like Entity certified by Centers for Medicare and Medicaid Services (CMS) founded by physicians in 1983. Headquartered in North Carolina’s Research Triangle, we offer an array of quality improvement, clinical review, audit, technical, and consulting services and solutions to improve care delivery, system performance, and patient outcomes.
What You’ll Do:
We are seeking an experienced clinician to guide the technical assistance and implementation support that we provide to hundreds of hospitals, nursing homes and outpatient practices for improving patient care and outcomes in a multi-state region.
We expect you to:
- Delivers technical assistance to assigned health care providers in a specific setting of care (nursing home, hospital or outpatient practice). Participates in FQS as assigned based on their setting of care and geographical location.
- Supports the coordinate, complement, or create activities arising from resource assessments (A3C).
- Conducts assessments and develops Quality Action Plan (QAP).
- Delivers customized technical assistance (TA) based on QAP, including data review, quality improvement (QI) coaching, and connection to local resources.
- Promptly and accurately records all QI data and information into the CMS-designated data system and HQI CRM as appropriate.
- Ability to interpret data, such as performance on clinical measures, and use it to guide recommendations for actions to improve results.
- Demonstrated success with customer service and engagement. Monitors and maintains engagement of assigned providers.
This position is contingent upon contract award and works remotely locally in Alabama or Mississippi, Approximately 20% travel within the southeast region may be required.
Our requirements for this role:
- Bachelor’s degree (health care administration, nursing, public health, other) plus 3+ years of relevant experience in health care QI or master’s degree w/o experience.
- CPHQ or Six Sigma Yellow Belt desirable.
- Clinical credentials or licensure (e.g., registered nurse, social work, or nursing home administrator) a plus but not required.
- Demonstrated ability to work collaboratively as part of a multidisciplinary team, including excellent interpersonal communication and teamwork skills.
- Excellent oral and written communication skills that include experience making presentations and conducting training sessions.
Why Constellation Quality Health?
We offer a competitive salary and benefits package and a flexible, supportive hybrid work environment.
Equal opportunity employer of protected veterans
Equal opportunity employer of individuals with disabilities
We do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, gender identity, national origin, medical condition, disability, veteran status, or any other basis protected by law
Applicants and employees are protected from discrimination based on inquiring about, disclosing, or discussing compensation or the compensation of other applicants or employees.
About the job
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
Applies specialized clinical and industry knowledge and performance improvement best practices to quality improvement efforts. Analyzes workflow and organizational performance to ensure continuous alignment with regulatory and accreditation standards. Oversees and ensures the implementation, measurement and evaluation of workplans. Provides insights and recommendations to optimize healthcare practices and achieve highest standards of care and service delivery, in alignment with industry and accreditation best practices.
Additional responsibilities to include but not limited to the following:
- Develops and implements quality improvement programs and initiatives to monitor and improve healthcare services and processes. Quantitatively and qualitatively analyzes organizational systems and performance in alignment with regulatory and accreditation standards.
- Drives and implements evidence-based performance improvement interventions that address areas for improvement, reduce variations in care, and enhance clinical effectiveness. Establishes, tracks and monitors process and outcome measures. Prepares organizational documents and effectiveness reporting in compliance with requirements.
- Manages and coordinates accreditation-specific workplans. Facilitates relevant workgroups and committees as required to ensure stakeholder awareness and participation to achieve continuous survey readiness.
- Contributes to enhancing healthcare services, improving patient outcomes, and ensuring adherence to regulatory requirements and industry standards.
- Contributes to the development, revision, and implementation of policies, procedures, and guidelines that focus on improving clinical quality and ensuring patient safety.
- Stays up-to-date on healthcare innovations, quality studies and evidence-based practices by participating in research efforts, contributing to scholarly publications, and/or facilitating research utilization to improve clinical care and outcomes.
- Provides training and education to healthcare professionals, staff, and stakeholders on quality assurance, patient safety, and compliance-related topics.
- Monitors and ensures compliance with relevant laws, regulations, and accreditation standards by conducting regular reviews, assessments, and audits to identify and address areas of non-compliance.
- Collaborates with cross-functional teams, such as legal, clinical operations, and regulatory affairs, to ensure policies are up-to-date, aligned with industry best practices, and reflect regulatory requirements.
Required Qualifications
- 3 years experience
- In depth knowledge of health plan accreditation standards and initiatives aimed to drive compliance
- Working knowledge of clinical and practice requirements essential to meet patient care needs.
- Ability to deal tactfully with customers and community.
- Ability to handle sensitive information ethically and responsibly.
- Ability to consider the relative costs and benefits of potential actions to choose the most appropriate option.
- Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients.
- Registered Nurse (RN) required.
Preferred Qualifications
- Master’s degree in healthcare related field
- Certified Professional in Healthcare Quality (CPHQ) preferred.
- Working knowledge of problem solving and decision making skills.
Education
Bachelor’s of Science in Nursing
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: 10/31/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.