Accreditation Manager

Summary

Join SmithRx, a rapidly growing Health-Tech company, as our Accreditation Manager! Lead our efforts in achieving and maintaining industry accreditations, ensuring compliance with standards. You will oversee accreditation compliance, interpret standards, and guide staff. This role involves meticulous audit management, promoting compliance, fostering continuous improvement, and enhancing operational efficiency. You will provide expert guidance and training, communicating effectively with accrediting bodies. This position is crucial for mitigating risks and ensuring sustainable compliance, supporting SmithRx's mission and long-term success. Applicants must be based in one of the specified states.

Requirements

• Minimum of 4 years combined experience in either Quality Improvement or Accreditation Coordination for PBM, Pharmacy, or Health Plan
• Ability to work without direct oversight, setting goals and deadlines, independently managing deadlines
• Experience in building internal and external relationships/partnerships
• Strong quality orientation including the ability to focus on details and adherence to standards
• Excellent communication and presentation skills, both verbal and written
• Ability to find a solution for or to deal proactively with work-related problems
• Strong organizational skills
• Proficiency in Microsoft Word, Excel, and PowerPoint applications

Responsibilities

• Lead initiative to obtain URAC accreditation for SmithRx
• Manage accreditation compliance, including interpreting standards, monitoring, and implementing quality improvement, while also leading project planning for URAC Accreditation achievement and maintenance
• Maintain full three-year accreditation status, monitor accreditation process/standards, and inform appropriate management and quality staff of any changes
• Educate staff about accreditation requirements, audit processes, and the importance of adhering to standards to maintain accreditation
• Serve as the primary point of contact with external accreditation bodies, preparing all necessary documents and managing communication
• Organize and maintain accurate records of audits and accreditation processes and prepare detailed reports for management and accrediting bodies
• Analyze audit and quality improvement findings to develop recommendations and collaborative corrective action plans, documenting all activities formally
• Monitor the implementation of corrective action plans, ensuring recommendations are followed to achieve compliance and service improvements, and present findings to relevant committees
• Organize and assist with document controls for all enterprise policies and procedures, working with departments when necessary to establish new controls and ensure / improve quality for the organization
• Lead efforts to work with Engineering and data teams in support of URAC Accreditation quality, crafting or reviewing or instilling controls and documentation as needed
• Ensure clear communication and organized information flow by coordinating committee meetings, preparing detailed minutes, and delivering impactful presentations to colleagues and management
• Ensure the organization meets all necessary standards and regulations required for accreditation and is compliant with requirements as audited
• Plan, coordinate, and conduct internal and external audits to evaluate the effectiveness of the organization's processes and controls related to accreditations
• Identify areas for improvement based on findings and work with relevant departments to implement necessary changes to enhance operational quality and compliance
• Support cross functional teams in creating policies, procedures, and operational structures to meet accreditation standards
• Identify potential risks related to accreditation compliance and audit requirements and develop strategies to mitigate them

Preferred Qualifications

• Bachelor’s Degree in Pharmacy or PharmD, or Nursing Degree
• Six Sigma and/or Lean experience

Benefits

• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance
• Flexible Spending Benefits
• 401(k) Retirement Savings Program
• Short-term and long-term disability
• Discretionary Paid Time Off
• 12 Paid Holidays
• Wellness Benefits
• Commuter Benefits
• Paid Parental Leave benefits
• Employee Assistance Program (EAP)
• Well-stocked kitchen in office locations
• Professional development and training opportunities