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Clinical Quality & Compliance RN at CVS Health - ApplyBlast

Clinical Quality & Compliance RN

CVS Health

2 months ago

3.2 on Glassdoor

Remote

Full Time

Senior

0 applicants

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About this role

The Clinical Quality & Compliance RN role at CVS Health focuses on ensuring utilization management processes meet regulatory, accreditation, and quality standards. The position involves leading audit and accreditation activities, analyzing compliance trends, and collaborating with cross‑functional teams to drive operational excellence and improve member care.

Responsibilities

Lead audit, accreditation, and regulatory submission activities
Coordinate and monitor operational oversight and critical deliverables
Analyze compliance trends and denial letter findings to drive improvements

Skills

Qualifications

Active RN licenseAssociate Degree in NursingBSN (preferred)

About CVS Health

cvshealth.com

Headquarters

Woonsocket, Rhode Island, United States

Company Size

10001+ employees

Founded

1963

View Profile

CVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.