Evaluates the quality and accuracy of transactions and/or communications with providers, groups, and/or policyholders.
Identifies, documents, and reports any transaction errors or communications issues in a timely manner to ensure prompt resolution.
Tracks and trends audit results, providing feedback effectively and professionally to management.
Identifies and reports on systemic issues which create ongoing quality concerns.
Generates monthly reports of audit findings, supports clients with issues identified and develops reports to assist management with information requested.
Produces other ad hoc reports as requested by internal and external clients.
Provides training, mentoring and support to quality and operations staff.
Associates at this level function as subject matter experts, conducting routine to complex audits, generally related to multiple functions on multiple systems platforms for multiple lines of business.
Works proactively and independently including facilitation of calibration sessions with clients and/or teams.

Requires high school diploma or equivalent (GED)
Minimum 5 years' experience or any combination of education and experience which would provide an equivalent background
Pharmacy tech experience highly preferred.
Pharmacy Experience preferred.

Pharmacy Quality Assurance Specialist

Key skills