General Information

CS Business QA Analyst II

Description

Business QA Analyst II

$58,642 - $77,700 - $96,758

“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:

Provides system technical analyst support for claims testing processes for new plan and product implementations. The overall responsibilities include development of quality assurance testing strategies, developing testing specifications to validate business requirements and ensuring adherence to defined business unit policies and procedures.

What You Get To Do:

• Recommends and/or makes decisions regarding the development and execution of testing strategies for individual clients and general test scenarios used across broader market segments
• Develops quality assurance testing strategies and quality testing specifications to validate business requirements
• Reviews, analyzes, and evaluates business test systems and end-user needs
• Performs process assurance functions to ensure testing requests and associated activities adhere to defined policies and procedures
• Defines and documents use requirements to assist in the development of custom test cases and develops test plans to support the requirement testing and validation phase
• Acts as the liaison between the testing and validation end-users, Implementations and IT department
• Partner with Implementation and Client Team Members to support the testing and validation requests for new product and plan implementations
• Ensures client configuration programming is complete and accurate to defined specifications
• Provide necessary support to software changes as well as ensures quality on-time deliverables
• Assists internal department with technical claims testing setup
• Provides direct support to the department in developing specification to create innovative tools and strategies for testing the coding and supporting structure of the pharmacy benefit plans to ensure accurate claims processing
• Provides technical support for Point of Service (POS) testing of new rates and pharmacy carrier edits to ensure accuracy and integrity of data prior to production
• Provides proactive client test plan design analysis that establishes further opportunities for ensuring the integrity of the benefit, pharmacy network, formulary and other edits applied to a client’s configuration for claims processing
• Develops project plans, prioritize project tasks, and provide status updates on project progress
• Works with business partners to develop and execute test plans for new client implementations, eligibility records, and benefit, group, & carrier linking
• Analyzes claims adjudication results against requirements and identifies and reports discrepancies and inaccuracies
• Makes recommendations and develops solutions to enhance the accuracy of POS system changes and configuration setups
• Determines accuracy of adjudication configurations and approves data changes from the test environment to production
• Mentor and train team members and peers
• Lead the Testing and Validation team in solving new and unexpected problems that arise during the implementation phase of the project
• Appropriately improves processes, open to suggestions and experimentation, interested in re-engineering only when measureable benefits can be gained
• Determines length and difficulty of tasks and projects, assigns task/people and anticipates problems or roadblocks
• Serves as a subject matter expert for claims adjudication configurations and expected outcomes
• Partners closely with Information Technology Data Programmers/Analysts in development of advanced/complex programming of modifications that impact the testing environment
• Provides recommendations for the maintenance of the claims testing environment
• Proactively seeks out opportunities to improve claims testing processes through technology and process improvement solutions
• Develops efficient SQL queries to research, gather data and identify solutions

Supervisory Responsibilities

This job has no supervisory responsibilities.

Education and/or Experience

For consideration candidates will need:

• Bachelor's degree from four-year college or university in computer science, business administration, management information systems, or closely related field
• At least three (3) or more years’ testing and validation experience in the healthcare industry with knowledge of pharmacy benefits and claims processing configurations
• Or equivalent combination of education and experience

Computer Skills

Advanced expertise is MS Office; Word, Excel, PowerPoint, Access and Outlook.  Working knowledge of Oracle, SQL, Visio, along with working knowledge of healthcare operating systems and MedImpact file layout specifications highly preferred.

Certificates, Licenses, Registrations

None currently required.

Other Skills and Abilities

• Ability to effectively balance a high volume of work and a variety of tasks; ability to prioritize urgent issues effectively
• Strong analytic, verbal and written communication skills
• Detail-oriented with high degree of accuracy and organizational skills
• Able to effectively work as a team player as well as independently
• Excellent investigative, problem resolution, judgment and decision-making skills required
• Excellent presentation and consultative skills, working with internal and external clients at various levels in the organization

Advancement from the Business QA I position to the Business QA Analyst II position requires the candidate demonstrate the more advanced skills and level proficiencies in the following:

• Demonstrated ability to mentor and train team members and peers
• Ability to lead the Testing and Validation team in solving new and unexpected problems that arise during the implementation phase of the project
• Advanced proficiency with key business applications such as MS Office tools, Golden 32 and others as applicable to the role
• Skills and ability to improve processes, open to suggestions and experimentation, interested in re-engineering only when measureable benefits can be gained
• Ability to make sound and timely decisions, uses a mixture of analysis, experience, judgment and wisdom, sought out by others for solutions
• Ability to scopes out length and difficulty of tasks or projects, assign tasks to people, anticipate  problems and roadblocks
• Skills and Ability to serve as a subject matter expert for claims adjudication configurations and expected outcomes

Travel

This position may require domestic travel and/or attendance maybe 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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