Informatics Manager - Quality - HEDIS

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Leverages technology and data to improve healthcare outcomes by designing, implementing, and maintaining health information systems, analyzing healthcare data, and utilizing technology to support clinical workflows and decision-making. Applies expertise in healthcare and information technology to ensure efficient data management, promote data-driven insights, and enhance the delivery of healthcare services. What you will do Assesses the requirements of the department and identifies integration opportunities for new technologies and system processes. Assists the team in the management of the data, reporting, and analytics function to help internal teams draw meaningful conclusions. Coaches the team on how to apply statistical and computational methods to analyze research data. Conducts thorough literature reviews to understand the current state of knowledge data management, information systems, machine learning, and artificial intelligence. Confers with industry partners on ways to apply research findings to real-world settings to advance industry knowledge. Designs a documentation system for the system to outline system specifications, architectural diagrams, and user guides. Determines best approaches to define data models, data integration processes, and data governance policies for the department. Develop

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Aetna Medical Economics Unit (MEU) has an exciting opportunity for a Senior Informatics Manager to join our Performance Guarantee and Operational Reporting Team. The Operational Reporting and Analytics team within MEU is responsible for operational measurement and analysis for all Care Management programs. The role is responsible for ensuring the accuracy, consistency, and integrity of measure specifications, validation processes, and reporting outputs that support clinical performance guarantee reporting. The Senior Informatics Manager will serve as a key liaison across business, clinical, underwriting, reporting, and technology teams to drive alignment on measure logic, data requirements, validation findings, and implementation strategies. Furthermore, this role will support efforts to drive continuous improvement. Responsibilities Develop and maintain clinical performance report logic/code and report production Compile detailed reporting requirements, understand clinical programs and workflows as well as data sources. Track progress against performance targets. Evaluate outcomes and communicate progress to stakeholders. Collaboration with Underwriting and Business Stakeholders. Required Qualifications 7+ years of experience in reporting and analytics with advanced SQL development, data mo

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Aetna Medical Economics Unit (MEU) has an exciting opportunity for a Senior Informatics Manager – QuickBase Developer to join our Performance Guarantee and Operational Reporting Team. The Operational Reporting and Analytics team within MEU is responsible for operational measurement and analysis for all Care Management programs. You will act as the analytic lead for complex projects involving multiple resources and tasks while providing support for business objectives. The role is responsible for ensuring the accuracy, consistency, and integrity of measured specifications, validation processes, and reporting outputs that support clinical performance guarantee reporting with focus on building out PG QuickBase strategy for tracking non-compliant review process. Furthermore, this role will support efforts to drive continuous improvement. Responsibilties Develop and maintain QuickBase applications Develop and maintain clinical performance report logic/code and report production Compile detailed reporting requirements, understand clinical programs and workflows as well as data sources. Track progress against performance targets. Collaboration with Underwriting and Business Stakeholders. Required Qualifications 7+ years of experience in reporting and analytics with advanced SQL development, data m

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. 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 We believe success requires flexibility, a positive outlook, sound judgment, and the ability to inspire change within a fast-growing environment. This team directly impacts patients by supporting systems and processes that enable efficient, high-quality, and safe healthcare delivery. The Manager position leads and executes projects and initiatives within an information technology environment, coordinating CVS Health and vendor resources as needed. This role serves as a bridge among clinical operations, Quality & Safety, internal audit partners, Epic teams, and enterprise EHR leadership, with a strong focus on policy clarity, workflow standardization, end-to-end audit support, and enterprise assessment of AI-enabled Epic tools and related technologies. Key Responsibilities Enterprise Clinical EHR Policy Development & Mainten

Senior Engineering Manager — Lab Execution Platform : Women’s Health About the Role This is your chance to own a platform that lab scientists rely on every single day—and to rebuild it from the ground up. You'll lead maintenance of our off-the-shelf Lab Execution System while driving its transition to a custom, in-house platform. Every improvement you ship makes lab operations faster, makes scientists' lives easier, and ultimately helps improve patient health outcomes. The work is real, the impact is immediate, and the customers are just down the hall. You'll treat Lab Operations and R&D as your primary customers, partnering with them to build an intuitive, efficient, scalable Lab Execution platform they'll love using. You'll lead a small, sharp team in a fast-moving Kanban or Scrum workflow, lean hard into a "do more with less" mindset, and put AI to work multiplying what your engineers can accomplish. You'll stay close to the code while leading with impact and kindness, because the best teams are healthy teams. Key Responsibilities Technical Leadership & Development Own the design, build, and maintenance of both the off-the-shelf and custom Lab Execution platforms, keeping high-throughput lab processes running without a hitch. Build an AI-forward team that reaches for modern tooling to move faster and ship smarter. Stay hands-on—dive into the code and test the system yourself to make it better. Build and scale cloud-based microservices and front-end applications that power real lab workflows. Set the bar for technical excellence: reliability, performance, and a user experience people actually enjoy. Own the CI/CD pipeline and lock in quality with automated testing. Architect infrastructure that scales effortlessly and stays cost-smart. Customer-Focused Collaboration Be the bridge between engineering and lab users, turning real-time feedback into rapid improvements. Build tight relationships with Lab Operations, R&D, and stakeholders so their needs stee

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Sr. Manager, Medical Policy Quality Assurance (QA) & Rework Remediation is responsible for managing the day-to-day operations of the Medical Policy quality assurance and remediation program. This role oversees quality reviews, issue intake, defect investigation, root cause analysis, corrective action implementation, remediation tracking, and closure validation activities to ensure the accuracy and integrity of Medical Policy implementation and policy coding. The Manager works collaboratively with Medical Policy, Clinical Operations, Configuration, Claims, Payment Integrity, Informatics, Compliance, Appeals, and Operational business partners to identify, investigate, remediate, and monitor policy-related defects and quality concerns. The role is accountable for maintaining audit-ready documentation, supporting governance processes, monitoring defect trends, and ensuring remediation activities are completed timely and effectively. This position serves as the operational leader responsible for executing the Medical Policy QA and remediation workflow and ensuring identified issues are addressed through sustainable corrective and preventive actions. Quality Assurance Management Manage the day-to-day execution of Medical Policy quality assurance activities. Oversee ongoing reviews of policy coding, implementation accuracy, operational w