Data Quality Assurance Analyst (Hybrid)

Description

Responsibilities

• Collaborate with the Assistant Director, Model Office Team, and IT Applications Development Team to support key Eligibility Department initiatives from an analysis and testing perspective
• Develop business test cases to test system logic changes and program modifications to ensure logic is operating according to business guidelines and design specifications
• Conduct User Acceptance Testing (UAT) for various Eligibility projects and analyze and document test results
• Develop ad-hoc data reports, using PL/SQL, in support of Eligibility initiatives
• Review, monitor, and analyze eligibility systemic data reports, vendor export files, and pre-edit reports for active working members, dependents, and retirees/spouses to ensure data integrity
• Review and monitor daily Eligibility Control reports and Eligibility Nightly Batch to ensure members are not incorrectly downgraded, suspended/terminated, and to report system discrepancies and anomalies
• Create data comparison analysis, reconciliation, review, and monitor systematic data reports to ensure the quality and integrity of the eligibility/enrollment data and evaluate results and report findings with recommendation for corrective action
• Support staff training and development by conducting eligibility training and testing protocols
• Develop, create and maintain standard operating procedures related to testing, quality assurance and controls and V3 eligibility logic rules across other functional areas
• Respond in a timely manner to the eligibility system and external vendor system/files for member inquiries (internal and external) via email, phone, and/or hard copies
• Perform additional duties and projects as assigned by management

Qualifications

• Bachelor’s degree or equivalent years of work experience required
• Minimum of four (4) years’ experience in data analysis (gathering and analyzing data for problems and issues)
• Demonstrated experience extracting and analyzing large-scale health data sets using PL/SQL
• Advanced level in MS Excel and Word; proficiency in PL/SQL required
• Proven experience in conducting application/systems testing and reviewing and analyzing requirements
• Experience with healthcare enrollment, eligibility, health coverage, Coordination of Benefits (COB), or Consolidated Omnibus Budget Reconciliation Act (COBRA) in a health insurance or benefits environment a plus
• Strong Interpersonal skills with attention to detail and accuracy; ability to interact and communicate well with all levels of staff; must be a strong critical thinker
• Ability to work well in a team environment, meet tight deadlines and handle several projects simultaneously
• Available to work evenings and weekends as needed

We offer extraordinary benefits including outstanding health, dental, pension and family benefits for most positions which are paid entirely by the Funds without co-payments, deductibles, or out-of-pocket expenses for covered services. We also offer tuition reimbursement, generous holiday, vacation, and sick leave, as well as a 401K plan.