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Accreditation Manager

Department: Compliance
Location: New York, NY

Location: Remote (For Non-Local) or Hybrid (Local to NYC area)

Position Summary:

Capital Rx is seeking a highly skilled Accreditation Manager to oversee and ensure compliance with industry standards and regulatory requirements. The ideal candidate will play a crucial role in maintaining and achieving accreditation statuses, contributing to the overall quality and integrity of our pharmacy benefit management services.

Position Responsibilities:

  • Lead the accreditation process for various industry standards, including URAC, NCQA, and other relevant certifications.
  • Develop and implement strategies to maintain compliance with regulatory requirements and accreditation standards.
  • Conduct internal audits and assessments to identify areas for improvement and ensure ongoing compliance.
  • Prepare and submit documentation required for accreditation and regulatory reviews.
  • Collaborate with internal teams to develop and implement policies and procedures that support accreditation requirements.
  • Provide training and support to staff on accreditation and compliance-related topics.
  • Monitor changes in industry standards and regulations to ensure the company remains compliant.
  • Serve as the primary point of contact for accreditation bodies and regulatory agencies.
  • Analyze and report on accreditation and compliance metrics to senior management.
  • Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Minimum Qualifications:

  • Bachelorís degree in Healthcare Administration, Pharmacy, or a related field.
  • 3+ years of experience in accreditation management or a related role.
  • Proven experience with accreditation processes and standards such as URAC, NCQA, etc.
  • Strong understanding of regulatory requirements in the healthcare industry.
  • Excellent organizational and project management skills.

Preferred Qualifications:

  • Masterís degree in Healthcare Administration, Business, or a related field.
  • 1+ years of experience in accreditation management.
  • Certification in Healthcare Compliance (CHC) or similar accreditation.
  • Experience in a pharmacy benefit management (PBM) or healthcare setting.
  • Strong analytical skills and attention to detail.

Base Salary: $105,000 - $135,000

Nothing in this position description restricts managementís right to assign or reassign duties and responsibilities to this job at any time.

About Capital Rx

Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nationís electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corpô, Capital Rx is executing its mission through the deployment of JUDIģ, the companyís cloud-native enterprise health platform, and a Single-Ledger Modelô, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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