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Quality Manager


Perform management level work overseeing all aspects of incident reporting, data gathering and data analytics.  Instill the practice and successful executing of incident review, research, root cause analysis, development/confirmation of corrective and preventative actions, documentation, and reporting for all members of the team.  Ensure member issues are resolved in a timely manner that meets or exceeds our standards.  Actively participate in the improvement of the overall process and provide leadership in resolving on-going issues with solid and measurable action plans.  Oversee Quality on the Incident Resolution team.

Essential Duties & Responsibilities

  • Manage and oversee the Quality Assurance Analysts and Quality Technicians while evaluating and delegating assignments based on needs and scope of work
  • Ensure performance metrics are met for the department (.i.e. turnaround times, productivity levels, etc.)
  • Accountable for monitoring/auditing incident resolutions process activities and communications to ensure proper procedures are being followed and the member experience meets or exceeds our standards
  • Actively participate in determining process and training improvements to address root causes found during monitoring and auditing activities
  • Accountable for reviewing, researching, and resolving incoming Incident Reports to address member issues
  • Responsible for taking all necessary steps to correct errors and ensure incidents are properly resolved in a timely manner
  • Ensure resolutions and denials are properly communicated to all appropriate personnel (i.e. Client Services, Member Services, Pharmacy, etc.)
  • Confirm all necessary actions have been completed to resolve Member issues
  • Lead meetings as needed to promote collaboration and implement actions to improve processes and the overall member experience
  • Ensure incidents and complaints are entered properly into the system
  • Effectively communicate information to direct reports, staff, and supervisors in an open and timely manner
  • Monitor reports and communicate information to key stakeholders in a timely manner
  • Use relevant quality and process management methods and make sure all staff members understand how to use them to improve the business (lean/six sigma, RPI, etc)
  • Partner with the Director of Quality and members of the executive team to develop an overarching quality/service excellence program
  • Responsible for other duties as assigned

Education and Experience

  • 4 Year Degree or Equivalent Combined Education/Work Experience preferred
  • Certified Pharmacy Technician required
  • Minimum of three years of pharmacy experience and direct customer interface/issue resolution
  • Minimum of three years supervisory experience
  • Proficient in Microsoft Word, Excel, and Outlook

Knowledge, Skills, and Abilities

  • Strong interpersonal and presentation skills coupled with exceptional written and verbal communication skills
  • Good understanding of business acumen
  • Strategic thinker, independent self-starter capable of detailed analysis and creative problem solving
  • Demonstrated ability to influence and motivate across all levels of employees in multiple locations
  • Six Sigma or other process management related experience with proven results
  • Comfortable with and excels in a fast-paced environment handling multiple activities or interruptions at once
  • Looks for opportunities and develops solutions to drive continuous improvement
  • Shows initiation, accountability, flexibility as well as maintains sensitivity in human relations
  • Strong aptitude for listening and being able to provide actionable feedback
  • Attention to detail.
  • Focused team player who can work in conjunction with customers, pharmacists, other departments, and management
  • Ability to work independently with little supervision and meet deadlines
  • Ability to perform repetitious work accurately
  • ·Ability to lead teams and oversee other employees effectively
  • Willingness to address difficult issues and make difficult calls when necessary

Work Environment / Physical Demands

This position is in both a typical office and the Mail Order Pharmacy department.  It may require prolonged sitting/standing in front of a computer as well as walking throughout the facility on a frequent basis.  This position requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment, including the operation of a standard computer and phone equipment.  It may involve occasional high stress situations when dealing with customers/clients/employees, and may require occasionally working long hours to complete the project at hand.  It may also require occasional overnight travel to other facilities for several days.  This position requires following job-related instructions and performing other job-related duties as necessary.



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