Job Description
Job Description
Purpose:
The Quality Operations Lead reports directly to the Account Director and plays a critical role in ensuring the program team is compliant with the quality and data metrics set forth by the manufacturer of one of RareMed’s dedicated programs. This role will monitor program activities to ensure compliance with all operating procedures, execute random and scheduled internal audits, facilitate various strategic quality improvement initiatives and evaluate ongoing effectiveness. The Quality Operations Lead will oversee audit call monitoring, review program performance, and will work closely with the Account Director, Program Manager, and the Operations Supervisors to identify trends in order to achieve high quality predictable results and optimal outcomes. This role will also be responsible, along with program leadership for managing ad-hoc projects, with a focus on creating tools, resources and trainings that enhance accuracy, productivity and overall performance of the program.
Responsibilities:
- Work independently to set quality program expectations related to delivering excellent customer service.
- Ensure quality measures are maintained by supporting the leadership and compliance teams in implementation of recommendations, keeping in mind adherence with documented current business rules, SOP’s and Work Instructions.
- Monitor compliance within the program SOPs, Work Instructions, Call Guides, completion time, and ensure adherence to quality expectations.
- Review, analyze, and follow-up on team processes to ensure all actions and tasks are compliant with program SOPs, Work Instructions and update as appropriate. Make recommendations to accomplish activities with the utmost efficiency.
- In collaboration with the program leadership team, assist in the development and delivery of onboarding, training, initial certification and maintaining records of annual trainings and recertification, including but not limited to, Adverse Event, Motivational Interviewing, updates and revisions to business, regulatory and compliance rules, and any operational changes related to program quality monitoring.
- Review adverse events and product complaints for accuracy and submit completed reports to appropriate third parties per business rules
- Perform ongoing scoring, calibration, evaluation of recorded inbound and outbound calls and corresponding documentation in conjunction with operations team to ensure quality program standards are met.
- Provide timely coaching and assess future training needs to ensure teams meet established manufacturer metrics.
- Responsible for identifying and monitoring trends from call monitoring and recommending process improvements when necessary.
- Meet with internal and external audiences to identify and problem solve Quality Improvement (QI) issues. Responsible for providing feedback on call monitoring and calibration results to Account Director, Program Manager and manufacturer.
- Perform quality documentation audits on patient files to evaluate if information was processed according to program SOPs.
- Monitor to ensure validity of defined data and reports. Collaborate across internal program teams and external departments to ensure accuracy and timely delivery to receiving parties. Investigate and identify root cause analysis of any contributing factors which may cause delays or barriers.
- Organize, compile, and report QI data to identify trends, establish priorities, and recommend improvement activities.
- Facilitate any external program audit request in collaboration with leadership and RareMed compliance team. Act upon any request for recommended revisions within the required time frame (usually 30 days).
- Independently manage and prioritize multiple project work streams to meet deadlines.
- Lead and participate in additional Quality & Special projects as needed upon request.
- This position may require flexibility in scheduling, with shifts occurring between 8:00AM and 8:00PM EST, Monday through Friday. Employees should be prepared to work within this time frame as needed.
- Other duties as assigned.
Required Qualifications:
- Bachelor’s Degree and/or equivalent work experience also considered
- 2 + years’ experience in healthcare management setting
- Prior experience in pharmacy, HUB service provider, or the healthcare industry, pertaining to quality improvement (QI) initiatives
- Previous call monitoring/ documentation monitoring experience
- Strong attention to detail isa must
- High level of independent judgement, individual initiative, and time management skills
- Ability to communicate effectively in a manner that is clear, logical, and consistent verbally and in writing
- Ability to manage multiple projects simultaneously
- Ability to manage deliverables in a fast-paced environment
- Proven ability to extract potential action items from data reports and trend success after implementation
- Proficient in Microsoft Office (Teams, Word, Power Point, Excel)
Preferred Qualifications:
- Experience documenting standard operating procedures, documenting program requirements, creating training materials and working directly with cross-functional teams
- Ability to resolve simple and/or complex analytical problems
- Ability to present statistical and technical data in a clear and understandable manner
Work Environment
RareMed offers a hybrid work structure, combining remote work and in-office requirements. The frequency of onsite requirements will vary depending on role, operational needs, meetings, client visits, or team collaboration activities. Employees must be within commuting distance to Pittsburgh, PA, and able to report to the office when needed. We will provide advance notice when possible. This role routinely involves standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. When telecommuting, employees must have reliable internet access to utilize required systems and software required for the position's responsibilities. The amount of time the employee is expected to work per day or pay period will not change while working from home. Employees are responsible for the set-up of their home office environment, including physical set-up, internet connection, phone line, electricity, lighting, comfortable temperature, furniture, etc. Employee’s teleworking space should be separate and distinct from their “home space” and allow for privacy.
Physical Demands
While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands and fingers, handle or feel; and reach with hands and arms.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function of the job.