General Information

Testing & Validation Analyst

Description

Testing & Validation Analyst

$50,667 - $66,500 - $82,333

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

The Scoop:

Performs claims adjudication testing and validation by developing and executing test plans, analyzing claims adjudication results in a test environment, validating benefits and pharmacy network configurations, and recommending adjudication changes/enhancements as necessary to deliver accurate Point of Service (POS) results. Collaborates with multiple business units, including Information Technology, and with customers to develop accurate coding specifications, ensure ongoing accuracy of adjudication configurations, and pre-production quality control of POS and systems changes. Adheres to strict procedural and quality standards, including thorough and accurate documentation, testing protocols, and claims analysis. Relies on experience, judgment, business applications & systems knowledge, and technical skill to plan and accomplish goals. A wide degree of creativity and latitude is expected. Extent of supervision ranges from moderate, to minimal, to independent based upon demonstrated skill and performance level as defined for the position. This position is part of a three level career path with progression opportunities described in the Analyst Career Path Guidelines.

What You Get To Do:

• Works with business partners to develop and execute test plans for claims adjudication configurations, including POS changes, new client implementations, benefits & pharmacy network change requests, eligibility records, and benefit, group, & carrier linking
• Writes and maintains detailed documentation of testing & validation activities including client specifications, expected outcomes, testing methodology & processes, test results, recommendations, version control, and configuration design
• Analyzes claims adjudication results and identifies discrepancies, inaccuracies, anomalies, and unexpected consequences
• Makes recommendations and develops solutions to enhance the accuracy of POS system changes and configuration setups
• Partners with Information Technology Data Programmers and Analysts in development of advanced/complex POS system programming
• Collaborates with Operations staff to ensure that client expectations are achieved through up-front clarification of specifications, design reviews, and development of best practice coding guidelines
• Advises and recommends configuration models to Benefits and Pharmacy Network staff
• Utilizes planning, prioritizing, and organizational skills to ensure timely deliverables, high levels of quality, and efficient use of resources to achieve claims adjudication accuracy
• Provides support to internal staff as an SME on POS adjudication capabilities through a queue
• Will create test claims to validate functionality within POS if documentation is insufficient to answer a client need
• Maintains commitment to operational goals in the face of obstacles
• Collaborates and cultivates positive relationships with internal and external customers through delivery of sustainable, measurable, accurate, reliable, and timely results that meet or exceed customer expectations
• Promptly responds to service failures, resolves issues, and escalates concerns as appropriate
• Promotes continuous improvement by ensuring adherence to quality principles
• Seeks out and actively participates in business initiatives that contribute to service excellence
• Actively participates in continued professional development to stay up-to-date on the latest technical enhancements and quality management best practices
• Based upon career path level, completes special projects and assignments (such as leading design reviews, gathering technical requirements, creating statements of work (SOW) for complex technical projects, mentoring/training staff, etc.)
• Demonstrate ability to appear for work on time, follow directions from a supervisor, interact well with co-workers, understand and follow work rules and procedures, comply with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment

Supervisory Responsibilities

This job has no supervisory responsibilities.

Education and/or Experience

For consideration candidates will need:

• Bachelor's degree (B.A.) from four-year college or university
• One (1) year of benefits coding or configuration experience required in Pharmacy Benefit Management (PBM), Pharmacy, or Managed Healthcare; or an equivalent combination of education and experience

Computer Skills

• Intermediate to advanced knowledge of MS Office / Word, PowerPoint, and Outlook
• Advanced knowledge of MS Excel
• Working knowledge of key business applications such as SQL queries, Oracle forms, Golden 32, MedAccess, MedAccess Classic, MS Access, MedOptimize, Visio, or others as applicable to the role
• Ability to run SQL queries and scripts

Certificates, Licenses, Registrations

Pharmacy Technician License or National Certification preferred but not required.

Other Skills and Abilities

Ability to gather business requirements and client specifications.

Travel

This position requires no travel; however, attendance may be required at various local conferences and meetings.

The Perks:

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

This position is eligible for Employee Referral Bonus at Level I

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

OSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

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