Quality Improvement Consultant, CarelonRx Pharmacy

About the position

Carelon is a proud member of the Elevance Health family of companies providing unparalleled level of service in pharmacy benefits. By leveraging the power of new technologies, our strong, clinical-first lens and deep pharmacy expertise, we are actively defining our innovative role in the industry. The Pharmacy Quality Improvement Consultant is responsible for generating process improvements that bring about measurable improvement in quality and/or efficiency. This role will analyze and summarize performance and quality data related to pharmacy programs and services; and leading quality improvement projects for CarelonRx. You will work in collaboration with subject matter experts to support CarelonRx accreditation activities and quality management program activities.

Responsibilities

• 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.
• Perform Root Cause Analysis, develop Corrective and Preventive Actions, and monitor CAPA reports.
• Lead quality improvement projects and teams to improve quality and operational processes as a result of opportunities identified through CAPA program, accreditation survey findings, quality assurance, internal audits, and activities related to the CarelonRx pharmacy strategy.
• Identify and implement Corrective and Preventive Actions.
• Analyze and resolve process problems, and collaborate with departments in solving problems.
• Assist with execution and collaboration of process improvement CarelonRx pharmacy Quality Management Program activities.
• Travel to sites to oversee the implementation and follow up of new and enhanced processes and programs.

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.

Nice-to-haves

• 3+ years of experience in healthcare quality related role such as Any experience as a quality analyst, administrator, coordinator, or quality improvement specialist.
• 3+ years of experience in pharmacy and/or healthcare; specially Home Delivery Pharmacy and Specialty Pharmacy.
• Six Sigma Green Belt Certification or equivalent.
• Project Management Certification.
• State or National Pharmacy Technician Registration/Certification; or any pharmacy technician or other relevant health care experience.
• Healthcare or Quality related certification.
• Certification in process improvement or project management.
• Demonstrated experience developing primary research methodologies, design, and analysis.

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs
• medical
• dental
• vision
• short and long term disability benefits
• 401(k) +match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources