QM Nurse Consultant

CVS Health • Indianapolis, IN • 2h ago

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.

Requisition Job Description

Primary Job Duties & Responsibilities

Develops and implements quality assurance programs and initiatives to monitor and improve healthcare services and processes.

Communicates with healthcare professionals to develop and implement quality improvement initiatives that enhance the quality and consistency of patient care.

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.

Contributes to the development, revision, and implementation of policies, procedures, and guidelines that focus on improving clinical quality and ensuring patient safety.

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.

Analyzes data, identifies trends, and implements evidence-based practices that address areas for improvement, reduce variations in care, and enhance clinical effectiveness.

Provides training and education to healthcare professionals, staff, and stakeholders on quality assurance, patient safety, and compliance-related topics.

Contributes to enhancing healthcare services, improving patient outcomes, and ensuring adherence to regulatory requirements and industry standards.

Stays up-to-date on healthcare 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.

Required Qualifications:

Registered Nurse (RN) required.

Working knowledge of problem solving and decision making skills.

Working knowledge of medical terminology.

Working knowledge of digital literacy skills.

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.

3-5 years of direct care clinical experience as an RN required.

Active and unrestricted RN licensure required in candidate's state of residence.

2 years' experience with MS Office suite applications including Excel. Strong computer skills utilizing multiple systems and applications at the same time.

Must have critical thinking skills.

Preferred Qualifications:

Certified Professional Coder (CPC) preferred.

Experience with ICD-10, CPT coding

Experience with QNXT

Experience with QuickBase.

Experience with Cotiviti Editing/CXT

Education:

Bachelor's degree preferred/specialized training/relevant professional qualification.

Prior Relevant Work Experience

3-5 years

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,095.00 - $155,538.00

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: 09/23/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. 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.

Similar Jobs

Registered Nurse - Inpatient Acute Care/Med Surg. - Oncology/Hematology/Palliative Care

Veterans Affairs, Veterans Health Administration • Indianapolis, IN • 1h ago

Hospital & Medical

Summary Inpatient Staff Registered Nurse (RN) is responsible for providing competent, evidence-based care to assigned patients and oversight of licensed vocational nurses/nursing assistants, as appropriate to the setting...

1h ago

Go to Apply

QM Nurse Consultant

CVS Health • Indianapolis, IN • 2h ago

Hospital & Medical

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 compan...

2h ago

Go to Apply

Physical Therapist Assistant

ATI Physical Therapy • Indianapolis, IN • 20h ago

Hospital & Medical

Overview Are you a Physical Therapist Assistant looking to thrive in a supportive, balanced environment? Join ATI, a leader in Physical Therapy, where you'll be part of a team redefining MSK care. With a mission to deliv...

20h ago

Go to Apply

Physical Therapist (PT) - Home Health

Staffing Care Pro, LLC • Indianapolis, IN • 20h ago

Hospital & Medical

Physical Therapist (PT) - Home Health Company:Staffing Care Pro Location:Indianapolis, IN Job Type:Full-Time - Direct Hire About Us: Staffing Care Pro is a healthcare staffing agency committed to delivering high-quality,...

20h ago

Go to Apply

Aetna Pharmacy Performance Analytics - Manager

CVS Health • Indianapolis, IN • 21h ago

Hospital & Medical

21h ago

Go to Apply

Aetna Pharmacy Performance Analytics - Senior Manager

CVS Health • Indianapolis, IN • 21h ago

Hospital & Medical

21h ago

Go to Apply

Advanced Practice Provider Specialist, Dermatology (Indiana/Michigan)

J&J Family of Companies • Indianapolis, IN • 21h ago

Hospital & Medical

At Johnson & Johnson,?we believe health is everything. Our strength in healthcare innovation empowers us to build a?world where complex diseases are prevented, treated, and cured,?where treatments are smarter and les...

21h ago

Go to Apply

Medical Technologist I

Labcorp • Indianapolis, IN • 1d ago

Hospital & Medical

$5,000 Sign-on Bonus Labcorp Employees not eligible for sign-on bonus At Labcorp, we believe in the power of science to change lives. We are a leading global life sciences company that delivers answers for crucial health...

1d ago

Go to Apply

Medical Technologist III

Labcorp • Indianapolis, IN • 1d ago

Hospital & Medical

$5,000 Sign-on Bonus Labcorp Employees not eligible for sign-on bonus Labcorp Drug Development, the world's most comprehensive drug development company, dedicated to improving healthcare and improving lives. Our unique p...

1d ago

Go to Apply

Customers Ops Healthcare Life Science Veeva CRM Consultant

Deloitte • Indianapolis, IN • 1d ago

Hospital & Medical

Customers Ops Healthcare Life Science Veeva CRM Consultant Our Deloitte Customer team empowers organizations to build deeper relationships with customers through innovative strategies, advanced analytics, Generative AI,...

1d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.