Pharmacy Quality Improvement Specialist

3 weeks ago


Woburn, Massachusetts, United States Elevance Health Full time

Pharmacy Quality Improvement Specialist

Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.

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

CarelonRx's Advanced Home Delivery and Specialty Pharmacy Quality Team is looking to hire a Pharmacy Quality Improvement Specialist. S/he will be responsible for analyzing and summarizing performance and quality data related to pharmacy programs and services; and leading quality improvement projects for CarelonRx. S/he will serve as the quality improvement and project management expert in process change/performance improvement to develop, execute, and monitor healthcare quality initiatives. S/he will work in collaboration with subject matter experts to support CarelonRx accreditation activities and quality management program activities Internal facing title: Process Improvement Consultant

How you will make an impact:

  • 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.
  • Perform continuous monitoring of process improvement activities to maintain controlled results.
  • Perform and compile results of audits on key processes and systems; identify and recommend areas of improvement.
  • Align activities and improvement projects to organizational mission, vision, values, goals, and objectives.
  • Develop and provide statistics related to quality improvement initiatives and projects or other quality related measures.
  • Create quality and process improvement plans that establish priorities for quality, safety, and performance improvement activities.
  • Lead and participate in quality committee meetings and focus groups to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge pertaining to new developments, requirements, and policies.
  • Identify and implement Corrective and Preventive Actions though the CAPA Program.
  • Perform Root Cause Analysis, develop Corrective and Preventive Actions, and monitor CAPA Reports.
  • Analyze and resolve process problems and collaborate with departments in solving problems.
  • Assist with execution and collaboration of CarelonRx pharmacy Quality Management Program activities.
  • Assist with accreditation quality measures and preparing the organization for accreditation and audits.
  • Assist with special projects at the discretion of leadership.
  • Travel to sites to oversee the implementation and follow up of new and enhanced processes and programs.

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:

  • 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.
  • Proficient in Microsoft Office


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