Accreditation Manager

Who We Are:

SmithRx is a rapidly growing, venture-backed Health-Tech company.  Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector by building a next-generation drug acquisition platform driven by cutting edge technology, innovative cost saving tools, and best-in-class customer service.  With hundreds of thousands of members onboarded since 2016, SmithRx has a solution that is resonating with clients all across the country.

We pride ourselves for our mission-driven and collaborative culture that inspires our employees to do their best work. We believe that the U.S healthcare system is in need of transformation, and we come to work each day dedicated to making that change a reality. At our core, we are guided by our company values:

• Integrity: Always operate with honesty and transparency so we earn the trust of our clients.
• Courage: Demonstrate the courage needed to take on a broken industry and continuously improve what we offer to optimize health outcomes.
• Together: Foster a collaborative and inclusive environment that values teamwork, respect, and open communication, and encourages creativity and diversity of thought.

Job Summary:

The Accreditation Manager leads SmithRx in achieving and maintaining industry accreditations, ensuring compliance with standards. This role oversees accreditation compliance, interprets standards, and guides staff on compliance. The Accreditation Manager also identifies quality opportunities and ensures operational processes align with standards.

The role safeguards the organization's accreditation status through meticulous audit management, promoting compliance with standards, fostering a culture of continuous improvement, and enhancing operational efficiency. The Accreditation Manager provides expert guidance, comprehensive training, and clear communication with accrediting bodies, playing a crucial role in mitigating risks and ensuring sustainable compliance, thereby supporting SmithRx's mission and long-term success.

In order to be eligible for this position applicants must be based in one of the following states:Arkansas, Arizona, California, Colorado, Florida, Georgia, Kansas, Minnesota, Missouri, Nevada, Ohio, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin.

What you will do:

Accreditation Leadership & Management

• Leads initiative to obtain URAC accreditation for SmithRx.
• Manages accreditation compliance, including interpreting standards, monitoring, and implementing quality improvement, while also leading project planning for URAC Accreditation achievement and maintenance.
• Maintains full three-year accreditation status, monitors accreditation process/standards, and informs appropriate management and quality staff of any changes. 
• Educate staff about accreditation requirements, audit processes, and the importance of adhering to standards to maintain accreditation.

Documentation & Reporting:

• Serves as the primary point of contact with external accreditation bodies, preparing all necessary documents and managing communication.
• Organize and maintain accurate records of audits and accreditation processes and prepare detailed reports for management and accrediting bodies.
• Analyzes audit and quality improvement findings to develop recommendations and collaborative corrective action plans, documenting all activities formally.
• Monitors the implementation of corrective action plans, ensuring recommendations are followed to achieve compliance and service improvements, and presents findings to relevant committees.
• Organize and assist with document controls for all enterprise policies and procedures, working with departments when necessary to establish new controls and ensure / improve quality for the organization.
• Lead efforts to work with Engineering and data teams in support of URAC Accreditation quality, crafting or reviewing or instilling controls and documentation as needed.
• Ensures clear communication and organized information flow by coordinating committee meetings, preparing detailed minutes, and delivering impactful presentations to colleagues and management.

Quality Improvement, Compliance & Auditing:

• Ensuring the organization meets all necessary standards and regulations required for accreditation and is compliant with requirements as audited.
• Planning, coordinating, and conducting internal and external audits to evaluate the effectiveness of the organization's processes and controls related to accreditations
• Identifying areas for improvement based on findings and working with relevant departments to implement necessary changes to enhance operational quality and compliance.
• Support cross functional teams in creating policies, procedures, and operational structures to meet accreditation standards.
• Identifying potential risks related to accreditation compliance and audit requirements and developing strategies to mitigate them.

What you will bring to SmithRx:

• Minimum of 4 years combined experience in either Quality Improvement or Accreditation Coordination for PBM, Pharmacy, or Health Plan.
• Bachelor’s Degree in Pharmacy or PharmD, or Nursing Degree is preferred. In lieu of this, we may also consider additional years of applicable work experience and/or a related degree in healthcare or MBA.
• Ability to work without direct oversight, setting goals and deadlines, independently managing deadlines.
• Experience in building internal and external relationships/partnerships.
• Strong quality orientation including the ability to focus on details and adherence to standards.
• Excellent communication and presentation skills, both verbal and written.
• Ability to find a solution for or to deal proactively with work-related problems.
• Strong organizational skills.
• Proficiency in Microsoft Word, Excel, and PowerPoint applications.
• Six Sigma and/or Lean experience is a plus.

What SmithRx Offers You: 

• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance
• Flexible Spending Benefits 
• 401(k) Retirement Savings Program 
• Short-term and long-term disability
• Discretionary Paid Time Off 
• 12 Paid Holidays
• Wellness Benefits
• Commuter Benefits 
• Paid Parental Leave benefits
• Employee Assistance Program (EAP)
• Well-stocked kitchen in office locations
• Professional development and training opportunities