Pharmacy Benefits QA Analyst

This is a fully remote position, open to applicants in Arizona, +26 more states.

📋 Description

• Communicate project progress and escalate issues to enhance workflow efficiency.

• Collaborate with engineers to implement system improvements that facilitate workflow automation.

• Become a subject matter expert on departmental standards and procedures.

• Improve test plans to ensure application functionality aligns with original specifications.

• Provide support for business application systems and uphold data integrity within plans.

• Track and record department metrics, pinpoint areas for process enhancement, and establish quality acceptance criteria.

• Identify opportunities for quality improvement and present findings to the Manager/Team Leaders for review and approval.

• Develop and execute daily audits to evaluate the quality and accuracy of the work produced by Benefit Configuration Specialists/Analysts.

• Ensure thorough and precise analysis of benefit plan designs throughout their lifecycle, from pre-implementation to post-implementation in pharmacy or medical environments.

⛳️ Requirements

• Bachelor’s degree or equivalent work experience in healthcare and/or PBM is required.

• A minimum of 4 years of experience as a Pharmacy QA Analyst is preferred.

• In-depth knowledge of benefits administration, configuration, eligibility requirements, benefit provisions, and enrollment processes is necessary.

• Strong analytical abilities with advanced proficiency in Microsoft Excel.

• Excellent communication skills, both in person and through conference calls or written correspondence.

• Self-motivated with the ability to make informed decisions, devise creative solutions to challenges, and fulfill commitments.

• A results-oriented mindset, focusing on problem-solving and efficiency.

• Adaptable and capable of thriving under the pressures of a fast-paced technology environment.

🏝️ Benefits

• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance as well as AD&D Insurance.

• Flexible Spending Benefits.

• 401(k) Retirement Savings Program.

• Short-term and long-term disability coverage.

• Discretionary Paid Time Off.

• 12 Paid Holidays.

• Wellness Benefits.

• Commuter Benefits.

• Paid Parental Leave benefits.

• Employee Assistance Program (EAP).

• Well-stocked kitchen available in office locations.

• Opportunities for professional development and training.