Director - Accreditation, Vendor Oversight & Quality Management

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AffirmedRx, a Public Benefit Corporation

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PBM • Pharmacy Benefit Management • Healthcare Analytics • Healthcare • Pharmaceuticals

11 - 50

Description

• Oversee the accreditation process for programs and courses, ensuring compliance with relevant standards and regulations. • Prepare and submit accreditation applications and reports. • Maintain up-to-date knowledge of accreditation requirements and best practices. • Design and develop comprehensive curriculum and training programs that meet industry standards and organizational goals. • Collaborate with subject matter experts to create engaging and effective learning materials. • Evaluate and update curriculum based on feedback and changing industry requirements. • Manage relationships with delegated vendors to ensure compliance with contractual obligations and performance standards. • Conduct regular vendor performance reviews and audits. • Develop and implement vendor management strategies to optimize service delivery and cost efficiency. • Lead and manage multiple projects from initiation to completion, ensuring they are delivered on time, within scope, and budget. • Develop project plans, timelines, and budgets. • Coordinate with cross-functional teams to ensure project objectives are met. • Develop and implement quality management systems to ensure compliance with PBM industry standards and regulatory requirements. • Monitor and evaluate the effectiveness of PBM quality management processes, including formulary management, claims processing, and customer service. • Conduct regular quality audits and assessments of PBM operations to identify areas for improvement. • Collaborate with cross-functional teams, including clinical, operations, and IT, to develop and implement quality improvement initiatives specific to PBM services. • Ensure that all PBM programs and services, such as medication therapy management and prior authorization processes, meet the highest standards of quality and performance. • Provide training and support to PBM staff on quality management principles and practices, focusing on areas such as compliance, data integrity, and customer satisfaction. • Maintain up-to-date knowledge of quality management best practices and trends in the PBM industry, including changes in regulations and emerging technologies.

Requirements

• Bachelor’s Degree in Business Administration, or a related field. A Master’s degree is preferred in Business Administration, or a related field. • Minimum of 10 years of experience in accreditation, vendor oversight, and quality management. • Strong understanding of industry standards and regulatory requirements. • Excellent project management skills with a proven ability to lead and manage multiple projects simultaneously. • Exceptional communication and interpersonal skills. • Ability to work collaboratively with cross-functional teams and external partners. • Strong analytical and problem-solving abilities. • Experience in a similar role within the pharmacy benefit management or healthcare industry. • Knowledge of current trends and best practices in delegation and accreditation. • Proficiency in data analysis and reporting tools. • Experience in managing remote or distributed teams. • May require up to 10% travel.

Benefits

• Competitive compensation, including equity, with health, dental, vision, and other benefits.