Pharmacy Quality Improvement Specialist
Elevance Health

Job Info

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Pharmacy Quality Improvement Specialist

This position will work a hybrid model (remote and office), 1-2 times per week. The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care.

The Pharmacy Quality Improvement Specialist is responsible for generating process improvements that bring about measurable improvement in quality and/or efficiency. Contributes to achieve department's objectives by serving as key contact for researching and implementing solutions and tools for new systems and other key operational improvements, provide guidance to leads, operations experts, associates, and/or managers on process improvement issues.

How you will make an impact:

• Represents the department on process improvement teams, special projects and implementation of new technology.
• Lead role in coordinating annual review/revision of procedures.
• Leads the training of associates when new processes or procedures are implemented. Communicates process information and facilitates workgroups to ensure accurate and consistent workload reporting.
• Review /analyze monthly workload reports to ensure goals are on-target (timeliness, backlog) across all operational sites. Identify areas of concern & implement corrective plans if necessary.
• Uses reports and production statistics to represent unit(s) in departmental process improvement and system changes and provides specialized input on reports to management.
• Travels to worksite and other locations as necessary.

Minimum Requirements:

Requires a BA/BS in a related field and minimum of 5 years related experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• Pharmacy Tech certification a plus.
• Certified Project Manger or Certified Professional Coder preferred.
• Healthcare related experience a plus.
• Previous experience in high-volume operations (Medical Review, Appeals, Claims, Customer Service) strongly preferred.
• Working Specialty or Front-end Pharmacy operations preferred.
• Demonstrate ability to analyze existing and potential workflows, processes, supporting systems, and procedures and identifying improvements strongly preferred.
• Excellent oral, written and interpersonal communication skills, strong analytical, organizational, planning, problem solving and project/decision facilitation skills strongly preferred.

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