Pharmacy Benefits QA Analyst

Responsibilities

• 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.
• Develop and deploy daily audits to assess the quality and accuracy of the Benefit Configuration Specialists/Analysts work products.
• Ensure the quality and accurate analysis of benefit plan designs throughout their lifecycle, from pre-implementation to post-implementation in pharmacy or medical settings.

Requirements

• Bachelor's degree or equivalent work experience in healthcare and/or PBM.
• Comprehensive knowledge of benefits administration, benefits configuration, eligibility requirements, benefit provisions, and enrollment protocols.
• 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.

Nice-to-Haves

• 4+ years of experience as a Pharmacy QA Analyst.