clinical oversight specialist

CVS Health

<div><p>At CVS Health, we&rsquo;re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.</p><p></p><p>
As the nation&rsquo;s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues &ndash; 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.</p><p></p><p><b>
Position Summary</b></p><p>
This position will be working from home anywhere in the continental US.</p><p>
Standard business hours Monday-Friday.</p><ul><li>
Accountable for conducting oversight of entities that are contracted to perform clinical functions on Aetna's behalf.</li><li>
Monitor and track delegated entities compliance with regulatory and NCQA requirements.</li><li>
Communicate to delegated entities about industry standards, Aetna policies, and best practices.</li><li>
Accountable for preparing delegation oversight resources for NCQA and regulatory reviews</li><li>
This position supports NCQA, CMS, and other regulatory compliance initiatives.</li></ul><p><b><br>
Required Qualifications</b></p><ul><li>
3&ndash;5 years of experience in Quality Management within the healthcare industry</li><li>
Demonstrated ability to consistently meet deadlines in a fast-paced environment</li><li>
Strong communication and interpersonal skills, with a proven ability to collaborate effectively across teams</li></ul><p><b><br>
Preferred Qualifications</b></p><ul><li>
2 to 3 years prior experience working in Commercial/Medicare or Medicaid lines of business</li><li>
Medical Terminology and Claims Experience</li><li>
QuickBase Experience</li><li>
Experience with flexing and shifting priorities</li><li>
Experience working independently and collaboratively to solve problems, make decisions, and complete work/projects</li><li>
Growth mindset (developing yourself and others) skills</li></ul><p><b><br>
Education</b></p><ul><li>
Bachelors Degree Preferred</li></ul><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$43,888.00 - $102,081.00<p></p><p>
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.</p><p><br>
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.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; 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:</p><ul><li><p><b>
Affordable medical plan options,</b> a <b>401(k) plan </b>(including matching company contributions), and an <b>employee stock purchase plan</b>.</p></li><li><p><b>
No-cost programs for all colleagues </b>including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</p></li><li><p><b>
Benefit solutions that address the different needs and preferences of our colleagues</b> 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.</p></li></ul><p></p><p>
For more information, visit https://jobs.cvshealth.com/us/en/benefits</p><p></p>
We anticipate the application window for this opening will close on: 11/21/2025<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Analyst, Health Care Quality Management - Work at Home

Lumos Pharma, Inc.

<div><div><b>Clinical Quality Assurance Specialist</b></div>
<div></div><div>Lumos Pharma is a clinical-stage biopharmaceutical company whose mission is to develop new therapies for people with rare diseases, prioritizing its focus where the medical need is high, and the pathophysiology is clear. We are committed to this mission and a strategy grounded upon time and cost-efficient drug development to deliver safe and effective therapies to patients. We take a patient-centric approach and maintain inspection-readiness across our programs.</div>
<div></div><div>This position reports to the Vice President, Quality and Compliance, and is responsible for providing quality oversight of clinical trial activities performed in compliance with Good Clinical Practices (GCP). This position also supports internal quality systems and compliance functions. The Clinical Quality Assurance Specialist is expected to execute established processes involving quality assurance, quality systems, and compliance.</div>
<div></div><div>ESSENTIAL FUNCTIONS</div>
<ul><li>Author, review, and/or approve SOPs, protocols, study plans, and other applicable clinical documents in accordance with GCP requirements</li>
<li>Provide input on protocol deviations and associated corrective/preventive actions involving clinical trials.</li>
<li>Perform audits of clinical trial sites and clinical studies (e.g., trial master file, clinical study report, etc.)</li>
<li>Complete required tasks in the electronic quality management system</li>
<li>Assist with training coordination, ensuring employees are up to date on quality and compliance requirements</li>
<li>Assist with audits of external suppliers</li>
<li>Routinely work with internal and external stakeholders to achieve cross-functional goals.</li>
<li>Each employee is responsible for financial and compliance controls as they relate to their roles. For example, being fiscally responsible in purchasing decisions and completing compliance training within the specified time frames.</li>
</ul><div><div><div>REQUIRED QUALIFICATIONS</div>
<div></div><div>Education</div>
<ul><li>Bachelor's Degree (four-year college or technical school) required, Field of Study: Biology, Chemistry, Health Administration, or related technical discipline</li>
</ul><div>EXPERIENCE</div>
<ul><li>1-3 years of experience in quality assurance within the pharmaceutical or biotech industry</li>
</ul>
<div></div><div>PREFERRED QUALIFICATIONS</div>
<ul><li>Knowledge of GMP and GCP regulations</li>
<li>Strong attention to detail, documentation accuracy, and organizational skills</li>
<li>Microsoft Office</li>
<li>Experience with MasterControl is desirable</li>
<li>Experience with CDER BIMO inspections is desirable</li>
</ul>
<div></div><div>COMPETENCIES</div>
<ul><li>Analytical Skills: Strong analytical skills with a strategic mindset for clinical development and commercialization.</li>
<li>Communication: Excellent communication skills, with the ability to clearly articulate complex scientific information to technical and non-technical audiences.</li>
<li>Relationship Builder: Ability to work effectively in a cross-functional team environment and to build relationships with internal and external stakeholders.</li>
<li>Business Acumen: Business acumen is the ability to understand and discriminate between various business-related topics and issues.</li>
<li>Decision-Making/Judgment: Decision-making skills look at the ability of the individual to select an effective course of action while controlling resources and expenditures.</li>
</ul>
<div></div><div>WORK ENVIRONMENT</div>
<div>This position can work remotely in the United States.</div>
<div></div><div>TRAVEL EXPECTATION</div>
<div>Up to 10%</div>
<div></div><div>What you can expect as a Lumosian</div>
<ul><li>Industry-competitive compensation</li>
<li>Generous health and welfare benefits, including company-paid dental and vision benefits with dependents coverage, short-term and long-term disability, and basic life Insurance.</li>
<li>Lumos covers 85 &ndash; 95% of the medical premium</li>
<li>Health Reimbursement Arrangement</li>
<li>8 weeks of fully paid parental leave for all new parents</li>
<li>Gym or fitness class reimbursement</li>
<li>401(k) with 5% employer contribution</li>
<li>Flexible work hours and location</li>
<li>Generous PTO policy</li>
<li>11 paid holidays in the US</li>
<li>Offices in Austin, TX, and Ames, IA</li></ul></div></div></div><div></div>

Clinical Quality Assurance Specialist

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Analyst, Health Care Quality Management - Work at Home

Analyst, Health Care Quality Management - Work at Home

Analyst, Health Care Quality Management - Work at Home

Analyst, Health Care Quality Management - Work at Home

Analyst, Health Care Quality Management - Work at Home

Analyst, Health Care Quality Management - Work at Home

Clinical Quality Assurance Specialist