Pharmacy Quality Improvement Specialist at Elevance Health in Mason, Ohio

Job Description:

Pharmacy Quality Improvement Specialist



This position will work a hybrid model (remote and office), 1-2 times per week. The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.


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


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.

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:

• Pharmacy Tech certification a plus.


• Certified Project Manger or Certified Professional Coder preferred.


• Healthcare related experience a plus.


• Previous experience in high-volume operations (Medical Review, Appeals, Claims, Customer Service) strongly preferred.


• Working Specialty or Front-end Pharmacy operations preferred.


• Demonstrate ability to analyze existing and potential workflows, processes, supporting systems, and procedures and identifying improvements strongly preferred.


• Excellent oral, written and interpersonal communication skills, strong analytical, organizational, planning, problem solving and project/decision facilitation skills strongly preferred.

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.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Apply Now