Overview:
The Quality Assurance Pharmacist is responsible for evaluating the work completed by pharmacy auditors to ensure accuracy, consistency, and compliance with client requirements, contractual obligations, and industry standards. This role is essential in maintaining the integrity of audit results and supporting continuous improvement in audit performance.
Key Responsibilities:
- Review audited pharmacy claims to confirm accuracy, completeness, and adherence to established audit protocols.
- Assess the clinical and professional judgment applied by auditors in evaluating prescription claims.
- Identify discrepancies or errors in audit findings and provide clear feedback or corrective guidance.
- Ensure compliance with client-specific audit requirements, payer policies, and relevant regulatory standards.
- Document review outcomes, track trends, and recommend process improvements or targeted training (new drugs on the market, summary of auditor reviews).
- Collaborate with audit leadership and quality teams to maintain high performance and consistency across audit staff.
Required Skills and Qualifications:
- Strong attention to detail and analytical thinking.
- Ability to evaluate prescription and dispensing records for accuracy and appropriateness.
- Excellent written and verbal communication skills.
- Proficiency with audit management systems and standard office software (e.g., Excel).
- 10 years experience from various industries (LTC, Retail, Hospital)
Licensed pharmacist requires graduating from a college or school of pharmacy accredited by the Accreditation Council for Pharmacy Education (ACPE), such as a Doctor of Pharmacy Program (Pharm. D.) program and passing the North American Pharmacist Licensure Exam, or NAPLEX.
Must be licensed in Massachusetts.
Benefits:
- Competitive salary $60-65
Job Types: Full-time, Part-time
Pay: $60.00 - $65.00 per hour
Work Location: Hybrid remote in Melrose, MA 02176
