Quality Manager
The Quality Manager at AffirmedRx is responsible for overseeing and implementing quality management programs to ensure compliance and high standards across healthcare operations. This role leads quality improvement initiatives to enhance patient care, streamline processes, and support overall organizational goals. The Quality Manager analyzes and interprets data to identify trends, uncover opportunities, and drive measurable improvements across healthcare and pharmacy benefit management services. This position also monitors and updates policies and procedures to ensure alignment with regulatory requirements and industry best practices. The Quality Manager collaborates with cross-functional teams to address challenges, develop solutions, and implement effective, sustainable process improvements.
Key responsibilities include developing, implementing, and managing quality improvement initiatives to enhance patient care and operational effectiveness. The Quality Manager identifies performance gaps and leads projects that drive measurable improvements and outcomes. They apply Lean, Six Sigma, and root cause analysis methodologies to streamline processes and foster a culture of continuous improvement and accountability across the organization.
The role requires ensuring quality programs align with federal, state, industry regulations and standards, as well as accreditation requirements. The Quality Manager works with the compliance team to integrate regulatory and accreditation updates into policies, procedures, and workflows. They establish, implement, and maintain quality assurance processes to evaluate compliance and reduce risk, partnering with leadership to address compliance issues and implement corrective actions.
The position involves analyzing and interpreting quality, operational, and patient care data to identify trends and opportunities. The Quality Manager develops and maintains dashboards, reports, and key performance indicators (KPIs). They use data insights to support strategic decision-making and continuous improvement efforts, presenting findings, recommendations, and progress updates to leadership and stakeholders.
The role requires partnering with clinical, operational, and pharmacy benefit management teams to improve processes. The Quality Manager facilitates meetings, training, and education to support quality initiatives and best practices. They communicate goals, progress, and outcomes clearly to diverse audiences and support change management to ensure successful implementation of quality programs.
The position requires a Bachelor’s degree in healthcare administration, business administration, public health, or related fields. Candidates should have 5+ years of experience in quality management, healthcare operations, or related roles. Proficiency in analyzing and interpreting data to identify trends and drive improvements in patient care processes is essential. Experience with data analysis tools and familiarity with pharmacy benefit management (PBM) or healthcare systems is preferred. Knowledge of quality improvement methodologies, including Lean, Six Sigma, and root cause analysis, is necessary to optimize processes. Strong written and oral communication skills are required for clear reporting, training, and stakeholder engagement. The ability to collaborate effectively with diverse cross-functional teams to achieve shared goals and elevate standards is important. Candidates should be skilled at identifying issues, developing solutions, and implementing process changes efficiently. A demonstrated dedication to continuous improvement and a commitment to operational excellence is expected.
AffirmedRx offers the opportunity to impact industry change in the pharmacy benefits management space while delivering the highest quality patient outcomes. The company fosters a culture where people thrive because when the team thrives, the business thrives. Competitive compensation, including health, dental, vision, and other benefits, is provided.