Accreditation Coordinator

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🔥 0 minutes ago

🥔 Idaho – Remote

🥔 Idaho – Remote

💵 $22 - $26 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Navitus Health Solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2003

⚕️ Healthcare Insurance

💊 Pharmaceuticals

🤝 B2B

Healthcare Insurance • Pharmaceuticals • B2B

Navitus Health Solutions is a pharmacy benefit manager (PBM) that provides transparent, people-centered pharmacy benefit solutions to health plans, employers, government programs and other plan sponsors. The company operates a 100% pass-through, cost-plus model that emphasizes lowering medication costs, managing formularies, specialty drug management (including a cost-plus specialty pharmacy), claims adjudication, pharmacy network management, and member enablement and support services. Navitus positions itself as a fiduciary partner focused on affordability, compliance, clinical quality and improving health outcomes through tailored PBM services and digital health integrations.

📋 Description

• Coordinates preparation of the current accreditation applications, maintains documentation to demonstrate compliance with accreditation standards and assists with on-site reviews. • Coordinates activities and maintains up-to-date resources of the Quality Program and quality performance, improvement, outcome management, and member safety. • Annotates and maintain policies and procedures related to quality oversight including, but not limited to, audit procedures, claims monitoring and validation, quality metrics, analytics, and quality performance goals. • Collects and prepares quality performance metrics to be reported at governance committees. • Aids in implementing new accreditations and/or updated standards when published and assists the responsible area in implementing change within required timeframes. • Assists functional owners with documenting and managing action plans if processes do not comply with requirements, including timeframes and specific actions required for compliance. • Assists with preparation of the annual Quality Management Program Descriptions • Ensures the accurate reporting of all quality errors and initiatives as defined by the overarching quality program and assists in maintaining the Lumicera Quality intranet site. • Assists with collecting root cause analysis of errors and assists in developing and implementing corrective actions or rapid process improvement plans. • Assists in the documentation and reporting of ongoing Quality Improvement Projects. • Other duties as assigned

🎯 Requirements

• High School or GED required • Bachelor’s degree or equivalent experience preferred • Computer skills required with proficiency in Microsoft Outlook, Word, Excel, PowerPoint, and SharePoint • Participate in, adhere to, and support compliance program objectives • The ability to consistently interact cooperatively and respectfully with other employees

🏖️ Benefits

• Health, Dental, and Vision insurance • 20 days paid time off • 4 weeks paid parental leave • 9 paid holidays • 401K company match of up to 5% - No vesting requirement • Adoption Assistance Program • Flexible Spending Account • Educational Assistance Plan and Professional Membership assistance • Referral Bonus Program – up to $750!