Process Improvement Auditor
Description:
Job Description
We’re Hiring: Process Improvement Auditor – Alivia Specialty Pharmacy
At Alivia Specialty Pharmacy, we are committed to continuous improvement, patient safety, and operational excellence. We’re currently seeking a Process Improvement Auditor to join our team and lead process evaluations that help us maintain the highest standards of pharmacy operations and regulatory compliance.
This role is essential in ensuring accuracy, efficiency, and quality across pharmacy workflows, directly impacting our ability to serve patients with excellence and integrity.
️ Key Responsibilities:
Conduct process audits within the specialty pharmacy setting
Evaluate effectiveness and efficiency of implemented workflows
Analyze operational data to measure process performance
Identify improvement opportunities and recommend corrective/preventive actions
Prepare detailed audit reports and share findings with management
Desired Experience & Competencies:
Previous experience in pre-authorization or health plan processes (preferred)
Strong communication, customer service, and interpersonal skills
Excellent attention to detail and organizational ability
Capacity to prioritize tasks in accordance with internal policies
Understanding of healthcare privacy protocols (HIPAA)
Proficient in MS Word and Excel; experience with pharmacy systems (CPR+ or ScriptMed preferred)
Knowledge of medications used in therapies for specific health conditions treated by the assigned pharmacy
Education, Licensure & Certifications Required:
Associate Degree and valid Pharmacy Technician license
Strong knowledge of pharmacy and medical benefit claims processing, PBM guidelines, and formularies
Familiarity with Medicare Part D, Part B, Medicaid, and commercial insurance regulations
At least 1 year of customer service experience related to benefit access processes
Certifications in HIPAA Security & Privacy, Confidentiality, and Fraud, Waste and Abuse (FWA)
Equal Opportunity Employer M/F/V/D
Full-time