Consultant, Accreditation Compliance

Navitus

Navitus
- Putting People First in Pharmacy
- Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other._____________________________________________________________________________________________________________________________________________________________________________________________________________.

Current associates must use SSO login option at  to be considered for internal opportunities. ____________________________________________________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

USD $71,716.00 - USD $86,405.00 /Yr.

7.50 - Salaried Non-Management except pharmacists

M-F 8am to 5pm

ATTENTION:
Lighthouse is only able to offer remote work to residents of Alabama, Arizona, California, Colorado, Connecticut, Dist. of Columbia, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Massachusetts, Maryland, Michigan, Minnesota, Missouri, Nevada, New Jersey, New York, Oregon, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin.

Navitus Health Solutions is seeking a Consultant, Accreditation Compliance to join our team!

The Consultant, Accreditation Compliance is a key member of the Accreditation Quality Team and is responsible for supporting and maintaining accreditation programs across Navitus. This role ensures compliance with accreditation standards delegated to or supported by Navitus Health Solutions through oversight of reporting, analysis, audits, validation activities, and continuous quality improvement initiatives. This role serves as a subject matter expert on accreditation standards and processes and provides consultation, guidance, and education to associates, leaders, clients, and other stakeholders.

The Consultant partners across the organization to support accreditation readiness, quality management activities, delegation oversight, performance improvement initiatives, and successful accreditation outcomes.

Is this you? Find out more below!

How do I make an impact on my team?

• Serve as a subject matter expert on accreditation standards, requirements, and interpretations; provide consultation, guidance, and training to associates, leaders, clients, consultants, and other stakeholders regarding accreditation expectations, compliance requirements, and best practices.
• Evaluate organizational practices, processes, and controls against applicable accreditation standards and identify opportunities to strengthen compliance, quality outcomes, and operational effectiveness.
• Serve as the primary liaison with accreditation organizations, consultants, and external stakeholders as appropriate, communicating accreditation updates, regulatory changes, and compliance requirements to support organizational readiness and ongoing compliance.
• Manage the Navitus Quality Management Program, including facilitating quarterly meetings, maintaining program documentation, and collaborating with departments to monitor performance metrics associated with applicable accreditation standards (e.g. URAC PBM, NCQA, etc.).
• Perform accreditation audits and assessments to evaluate compliance with applicable standards, identify performance gaps, and recommend corrective actions.
• Evaluate and enhance audit methodologies, quality processes, and performance measurement tools to improve operational efficiency, accreditation readiness, and organizational outcomes.
• Lead root cause analysis activities and partner with stakeholders to develop, implement, and monitor corrective action plans that address compliance risks and improve organizational performance.
• Collect and analyze quantitative and qualitative data, identify trends, risks, and opportunities, and provide recommendations that…