Project & Program Management Quality Tester, Consultant I
Allstate
QA Analyst – PBM Implementation
Prime Therapeutics
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $59,000 - $94,000 per year
Job Level
JuniorMid-Level
About the role
- Perform research and assist leadership in identification of potential missed turnaround times on review related to applicable quality tests
- Perform ongoing inter-rater reliability exercises and quality reviews for less tenured staff and provide performance feedback and information to identify areas of improvement
- Perform complex quality reviews and analysis of cases to prevent errors based on strict compliance, service level agreements, and regulatory guidance
- Discover outliers and areas of improvement on work product of reviewers; provide feedback for improvement to prevent quality issues
- Assist in the gathering, documenting, and implementations of requirements for new and future system enhancements
- Serve as liaison for directing unresolved issues for further evaluation and resolution
- Collaborate with trainers and writers to provide feedback for training modules and documentation
- Other duties as assigned
Requirements
- Bachelor's degree in Business, Liberal Arts, or related area of study, or equivalent combination of education and/or related work experience; HS diploma or GED is required
- 2 years of experience within Claims Processing, Audit, Quality or Pharmacy
- Must be eligible to work in the United States without need for work visa or residency sponsorship
- 1 year of experience as a Clinical Review Technician or 2 years of experience in Clinical Review if position sits within Clinical Review Department
- National Pharmacy Technician Certification through PTCB or ExCPT (CPhT) and 2 years of experience working directly in a pharmacy if position sits within Pharmacy Audit department
Benefits
- Health insurance
- Flexible work arrangements
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
quality reviewsdata analysisperformance feedbackrequirements gatheringsystem enhancementscomplianceservice level agreementsinter-rater reliabilityclaims processingclinical review
Soft skills
collaborationcommunicationproblem-solvingfeedback provisionorganizational skillsleadershiptraining supportevaluationadaptabilityattention to detail
Certifications
Bachelor's degreeNational Pharmacy Technician CertificationPTCBExCPTCPhT
