Pharmacy Quality Assurance Specialist

YOUR PASSION, ACTIONS & FOCUS is our Strength

Become one of our Contributors

Join the KnipperHEALTH Team!

POSITION SUMMARY:

The Quality Assurance Specialist (QAS) assesses calls for quality, efficiency, and productivity. The QAS will monitor calls to determine representative’s demeanor, technical accuracy, performance and conformity to company policy and client program guidelines. Our ideal candidate is a team-oriented individual who is driven to assure that professionalism, productivity, and quality are maintained and continually improved. The QAS will have the responsibility to monitor patient support center call operations, to ensure every patient or prescriber receives a consistently positive experience.

• Maintain a thorough knowledge of client program expectations, KPIs, and policies
• Ensure compliance with all regulation including HIPAA and credit card security
• Review calls for multiple programs to ensure they meet program guidelines and expected execution
• Maintain accurate and sufficient documentation of calls via QA scorecards, including positive observations, as well as areas of needed improvement
• Provide ongoing QA Call Evaluation reporting and notification to Pharmacy Leadership
• Review patient enrollment, prescriptions, and case data for accuracy
• Provide coaching to contributors as required
• Collaborate with the Pharmacy Training Department and Pharmacy Operations to help grow contributors’ performance
• Provide daily, weekly, and monthly reporting
• Assist in new client and program implementation as requested by Pharmacy Leadership
• Perform user acceptance testing for various projects as requested by Pharmacy Leadership. Perform other duties as assigned.

The above duties are meant to be representative of the position and not all-inclusive.

MINIMUM JOB REQUIREMENTS:

• High School Diploma
• Ability to read, write, speak and understand the English language.
• Prior experience in training, lead roles, or supervisory experience within a contact center or customer facing environment

PREFERRED EDUCATION AND EXPERIENCE

• Nationally certified through the PTCB or another approved certifying agency
• Experience with drug reimbursement issues and claim adjudication process
• Experience with insurance benefits investigations; knowledge of U.S. Private and Government payers
• Experience with HIPAA, PDMA, cGMP adverse events

KNOWLEDGE, SKILLS & ABILITIES:

• Ability to monitor and record improvements in performance
• Ability to provide feedback and demonstrate a variety of coaching methods
• Ability to write reports and business correspondence
• Ability to communicate effectively both orally and in writing
• Ability to build and maintain effective working relationships
• Strong attention to detail
• Deal with people in a manner which shows sensitivity, tact, and professionalism
• Powerful desire to help people resolve problems and excel at job skills
• Able to work under pressure and ability to multi-task
• Creative problem solver and effective at conflict resolution

PHYSICAL DEMANDS:

• Location of job activities 100% inside
• Extensive manual dexterity (keyboarding, mouse, phone)
• Constant use of phone for communication
• Noise and/or vibrations exposure
• Frequently reach (overhead), handle, and feel with hands and arms
• Sit for prolonged periods of time
• Occasionally stoop, kneel, and crouch
• Occasionally lift, carry, and move up to 25 pounds

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.