Pharmacy Quality Improvement Specialist

Anticipated End Date:

2025-09-01

Position Title:

Pharmacy Quality Improvement Specialist

Job Description:

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.

Pharmacy Quality Improvement Specialist

Location: This role requires associates to be in-office 1 day per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Schedule: Monday - Friday; 8:00am-5:00pm

The Pharmacy Quality Improvement Specialist is responsible for generating process improvements that bring about measurable improvement in quality and/or efficiency. Contributes to achieve department's objectives by serving as key contact for researching and implementing solutions and tools for new systems and other key operational improvements, provide guidance to leads, operations experts, associates, and/or managers on process improvement issues.

How you will make an impact:  

• 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.

• Travels to worksite and other locations as necessary.

• 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 process improvement CarelonRx pharmacy Quality Management Program activities.

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.

Job Level:

Non-Management Exempt

Workshift:

Job Family:

BSP > Process Improvement

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

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