Pharmacy Benefits QA Analyst - Remote

Overview

As a Benefits Quality Assurance Analyst, you will be responsible for overseeing the core operations, processes, and quality standards of the benefits plan build and maintenance to ensure the delivery of a high quality SmithRx product.

In Short

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

Requirements

• Bachelors degree or equivalent work experience in healthcare and/or PBM required
• 4+ years of experience as a Pharmacy QA Analyst preferred
• Comprehensive knowledge of benefits administration, benefits configuration, eligibility requirements, benefit provisions, and enrollment protocols required
• 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

Benefits

• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance
• Flexible Spending Benefits
• 401(k) Retirement Savings Program
• Short-term and long-term disability
• Discretionary Paid Time Off
• 12 Paid Holidays
• Wellness Benefits
• Commuter Benefits
• Paid Parental Leave benefits
• Employee Assistance Program (EAP)
• Well-stocked kitchen in office locations
• Professional development and training opportunities