Accreditation, Quality & URL Specialist

MedImpact•San Diego, CA

1d•Onsite

About The Position

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team! Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare. At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution! Job Description Summary Responsible for the execution of the annual accreditation and UR assessment process and work plan to maintain MedImpact accreditation and state UR licensure requirements. Coordinates with internal partners to accomplish assigned accreditation and compliance activities.

Requirements

BS/BA and 5+ years’ experience or equivalent combination of education and experience, and 3 years of SME in respective areas
To perform this job successfully, an individual should have intermediate working knowledge of Microsoft Office Suite (Word/Excel/Access/Outlook) and Adobe Acrobat.
Based on the clinical nature of the work, unencumbered healthcare related license is required.
Examples of applicable licenses include Pharmacy Technician (CPT), Medical Assistant (MA), and/or Registered Nurse (RN).
Experience managing operational projects from inception to completion as well as team leadership and facilitation responsibilities
Ability to gather requirements as well as prepare and maintain detailed product/project plans to support accreditation and quality management activities
Good interpersonal skills with the ability to work independently and as part of a cohesive team
Ability to work in a dynamic environment with constantly changing deliverables
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
Ability to deal with problems involving several concrete variables in standardized situations.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
Ability to write routine reports and correspondence.
Ability to speak effectively before groups of customers or employees of organization.

Responsibilities

Performs accreditation and quality management related audits and activities with an emphasis on obtaining or maintaining accreditation and UR licensure.
Participates in onsite audits/reviews, agency inquiries, and training employees, as needed.
Performs ongoing monitoring to ensure the organization is meeting accreditation standards.
Analyzes data, workflows, policies and procedures to assess program effectiveness.
Interprets significance of routine-intermediate findings to identify areas of improvement, make and implement recommendations for improvement.
Defines and documents accreditation and compliance process steps (i.e., policy and procedures) in accordance with current state, federal, and independent accreditation and UR licensing requirements.
Communicates and consults with internal partners to assist with the implementation of accreditation and compliance recommendations for assigned area(s).
Serves as accreditation subject-matter expert for all or specific program sections, to consult and update internal partners on accreditation efforts and requirements.
May recommend and provide training to employees regarding accreditation and compliance requirements and procedures.
Stays current with accreditation and regulatory requirements, as well as PA/UM programs in an effort to consult and provide a mutually beneficial resolution.