Pharmacy Benefits QA Analyst

SmithRx

. Communicate project status and escalate issues for improved workflow efficiency .

Posted 5/16/2026full-timeRemote • Arizona, California, Colorado, Connecticut, Florida, Illinois, Kansas, Kentucky, Maryland, Massachusetts, Minnesota, Montana, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

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

What you’ll need

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

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

benefits administrationbenefits configurationeligibility requirementsbenefit provisionsenrollment protocolsanalytical skillsMicrosoft Excelquality assuranceworkflow automationtest plans

Soft Skills

communication skillsself-starter mentalityproblem solvingefficiency drivenflexibilityadaptabilitydecision makingcreativitycollaborationproject management

Certifications

Bachelor's degree