Consultant, Accreditation Compliance

🔥 13 hours ago

🇺🇸 United States – Remote

💵 $71.7k - $86.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Navitus Health Solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2003

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

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

• Serve as a subject matter expert on accreditation standards, requirements, and interpretations. • Provide consultation, guidance, and training to associates, leaders, clients, consultants, and other stakeholders. • Evaluate organizational practices, processes, and controls against applicable accreditation standards. • Serve as primary liaison with accreditation organizations, consultants, and external stakeholders. • Manage the Navitus Quality Management Program, including quarterly meetings, documentation, and performance metric monitoring. • Perform accreditation audits and assessments and recommend corrective actions. • Enhance audit methodologies, quality processes, and performance measurement tools. • Lead root cause analysis and corrective action planning. • Collect and analyze quantitative and qualitative data to identify trends, risks, and opportunities. • Develop and maintain documentation, strategies, processes, and objectives supporting accreditation. • Lead accreditation surveys and reviews, including preparation, coordination, facilitation, communication, and follow-up. • Participate in client meetings and accreditation activities. • Develop and maintain client-specific delegation agreements. • Perform other duties as assigned.

🎯 Requirements

• Bachelor’s degree required in Healthcare Administration, Quality Management, Business Administration, Public Health, Pharmacy, or a related field, or equivalent work experience, required. • 5+ years of experience in accreditation, compliance, quality management, or a related field required. • Experience with accreditation programs such as URAC, NCQA, or similar accreditation organizations required. • Experience interpreting and applying accreditation standards and leading accreditation readiness, survey preparation, audit, or compliance activities required. • Participate in, adhere to, and support compliance program objectives. • The ability to consistently interact cooperatively and respectfully with other employees. • Availability to work M-F 8am to 5pm. • Remote work is unavailable to residents of Alaska, Delaware, Hawaii, Idaho, Iowa, Louisiana, Maine, Mississippi, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming.

🏖️ Benefits

• Top of the industry benefits for 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!