Added
11 days ago
Type
Full time
Salary
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auditing compliance quality assurance dispensing claims processing
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๐Ÿ“‹ Description

  • Own the end-to-end quality audit program for order processing, claims, prior authorizations
  • Maintain a working audit caseload alongside the team to model best practices and demonstrate audit
  • Develop, document, and continuously improve QA scorecards, audit tools, SOPs, and calibration
  • Serve as the escalation point for quality concerns, leading root cause analysis, real-time
  • Stay current on workflow changes, payer requirements, and clinic-specific expectations and
  • Lead, coach, and develop a team of Quality Specialists, fostering a culture of accountability

๐ŸŽฏ Requirements

  • 5+ years of experience in pharmacy operations, including claims processing, prior authorizations
  • 2+ years in a quality assurance, auditing, or compliance capacity.
  • Specialty pharmacy experience required; medically integrated dispensing experience preferred.
  • 2+ years of supervisory, lead, or mentoring experience, or a demonstrated record of informally
  • Strong understanding of specialty pharmacy workflows, SOPs, and the importance of accuracy at every
  • Proficient in analyzing data, synthesizing insights, and driving improvement through data-driven

๐ŸŽ Benefits

  • Base salary/wage will depend on several factors, including experience, knowledge, and skills.
  • Actual compensation packages may include other elements such as equity, paid time off, and benefits.
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