Pharmacy Benefits QA Analyst
SmithRx
full-time
Posted on:
Location Type: Remote
Location: Remote • Arizona, California, Colorado, Florida, Kansas, Minnesota, Montana, Nevada, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Communicate project status and escalate issues for improved workflow efficiency
- Collaborate with engineers on system enhancements to create workflow automation
- Become subject matter expert on department standards and processes
- Enhance test plans to ensure application functionality meets original requirements
- Support business application systems and maintain plan data integrity
- Maintain and capture department metrics, identify areas of opportunity for process improvement, and develop quality acceptance standards.
- Identify quality improvement opportunities and present to Manager/Team Leaders for consideration and approval
- Develops and deploys daily audits to assess the quality and accuracy of the Benefit Configuration Specialists/Analysts work products.
- Ensures the quality and accurate analysis of benefit plan designs throughout their lifecycle, from pre-implementation to post-implementation in pharmacy or medical settings.
Requirements
- Bachelors degree or equivalent work experience in healthcare and/or PBM required
- 4+ years of experience as a Pharmacy QA Analyst preferred
- Comprehensive knowledge of benefits administration, benefits configuration, eligibility requirements, benefit provisions, and enrollment protocols required
- Robust analytical skills; advanced skills in Microsoft Excel
- Strong communication skills via face-to-face meetings, conference calls and written correspondence
- Self-starter mentality: ability to make informed decisions, find creative approaches to difficult challenges, and deliver on commitments
- Execution-focused ethos - you are a solutions-oriented problem solver and efficiency driven
- Flexible, adaptable, and able to respond under the pressure of a fast-paced technology company
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
benefits administrationbenefits configurationeligibility requirementsbenefit provisionsenrollment protocolsanalytical skillsMicrosoft Excelquality assuranceworkflow automationtest plans
Soft skills
communication skillsself-starter mentalityproblem solvingexecution-focusedflexibilityadaptabilitydecision makingcreativityefficiency drivencollaboration
Certifications
Bachelor's degree