Accreditation and Audit Manager (Individual Contributor) at CVS Health

Raleigh, North Carolina, United States -

Full Time

Start Date

Immediate

Expiry Date

07 Feb, 26

Salary

145860.0

Posted On

09 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Effective Written Communication, Effective Verbal Communication, Strong Presentation Skills, Critical Analysis, Planning, Organizing, Evaluating, Quality Improvement, Compliance, Audits, Accreditation, Document Review, Clinical File Review, Collaboration, Metrics Monitoring, Feedback Provision

Industry

Hospitals and Health Care

Description

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 As the Accreditation and Audit Manager for CVS Health, you'll be responsible for organizing, leading, and ensuring completion of activities related to internal and external audit requests. You are accountable for managing accreditation and audit timelines, identifying appropriate resources, and collaborating with subject matter experts in order to support audit and accreditation preparation and successful audit review and compliance. You will develop a deep understanding of the program objectives, policies and procedures, internal workflows, client workflows, client contractual obligations and accreditation requirements, and acts as a resource for the organization related to audit and accreditation topics. You'll complete preparation of gap analyses, document review, document preparation, clinical file review and other activities to ensure on-going accreditation compliance and completion of successful accreditation surveys. Additionally, you will create and monitor metrics related to audit activities to ensure that audit deliverables are met. You will provide feedback and recommendations regarding improvement opportunities and collaborates with relevant teams/departments in quality improvement activities. Other duties include: Develop and maintain deep domain knowledge related to assigned products, CVSH policies and procedures, client contract requirements related to program delivery, accreditation standards, and other requirements. Support accreditation preparation through gap analyses, document review and preparation, clinical file review, presentation of clinical and licensing files and other activities to ensure successful accreditation. Prepare and ensure proper preparation and presentation of documents to support compliance with audit requests, following CVSH guidelines for document preparation and release. Work across teams, departments and CVSH to secure relevant subject matter expertise to meet audit and accreditation requirements. Collaborate with Sales, Account Management, and the Clinical Teams in preparation and/or presentation of audit documents. Provide relevant insight and guidance to the Clinical Teams and other departments regarding compliance gaps; identifies and makes recommendations regarding improvement opportunities and supports continuous quality improvement activities. Participate in committees and workgroups focused on healthcare quality and process improvement methodologies. Create and monitor metrics related to audit activities to ensure that audit and accreditation deliverables are met. To be a candidate you will possess the following: Effective written and verbal communication skills. Strong presentation skills. Ability to adapt to change, perform critical analysis, plan, organize and evaluate effectively. ***This is a remote role. Candidates can live anywhere in the US*** Required Qualifications 5 years of experience in quality improvements, compliance and audits or accreditation Experience with Microsoft Office Products Preferred Qualifications Nursing experience Education Bachelor's degree or equivelent experience required. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,300.00 - $145,860.00 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: 11/22/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Responsibilities

The Accreditation and Audit Manager is responsible for organizing and leading activities related to internal and external audit requests, ensuring compliance with accreditation standards. This role involves managing timelines, collaborating with subject matter experts, and preparing necessary documentation for successful audits.