Senior Manager QIA -Duals

Job DescriptionFully remote role with potential for very minimal travel.Schedule: Monday-Friday 8am-5pm EST.As the Senior Manager of Quality Improvement Activities (QIA) in the rapidly growing Duals organization, you'll be supporting the Duals National Program Office clinical transformation work to improve health outcomes through the identification and execution of activities such as quality reporting, effective case management, care coordination, chronic disease management, and medication and care compliance initiatives.Responsible for leading/managing all aspects of QIA/clinical initiatives to increase the likelihood of desired health outcomes in ways that are capable of being objectively measured and of producing verifiable results and achievements. Ensure identification and strategic management of clinical pipeline and priorities. Work with key stakeholders (i.e. clinical, finance, legal, compliance) to prepare QIA committee materials, present in-depth overview of the initiative(s), oversight of initiative implementation, and disseminate information to key stakeholders and senior leadership. Develop clinical reporting metrics such as operational performance and outcome measures as well as maintain formal documentation repository for tracking all initiatives (past, present, future). This is a highly collaborative role working with business partners including clinical teams, finance, legal, compliance, and executive leadership across Aetna and CVS organizations to enhance our member health outcomes.Responsibilities include: Drive QIA/clinical initiative performance focus Set clinical strategy, pipeline, stakeholder alignment Prepare and deliver QIA/clinical initiatives to QIA committee Work with market performance team to determine appropriate program investments and track MLR Work in concepts of investing in innovation, partnering with CVS assets, SDOH, and health equity Develop tracking and monitoring repository Define/report measurement of goals and outcomes against expected performance Prepare and deliver operational performance reports Engage subject matter experts across the organization to implement and execute deliverablesPay RangeThe typical pay range for this role is:Minimum: 75,400Maximum: 158,300Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications Active and good standing RN license in their state of residence 5+ years of experience in Medicare and/or Medicaid managed care 5+ years of experience working with special needs populations (LTSS, DSNP, ISNP, CSNP and/or MMP) 3+ years of experience in development of QIAs including financial allocation 3+ years of leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes 3+ years of clinical program design experience working with cross-functional teamsPreferred Qualifications Experience in strategic management of clinical products and programs Demonstrated ability to synthesize and communicate program performance and outcomes Demonstrated problem-solving skills with the ability to deal effectively with constant change Ability to communicate effectively and work cross-functionally at all levels of an organization including with senior leaders Excellent verbal, written and interpersonal skills Proficiency in Microsoft Excel, Microsoft Word, and Microsoft PowerPointEducationBachelor's degree minimum in Nursing or related clinical fieldBusiness OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2026-03-07