QA Analyst PBM Implementation – Remote

Our work matters. We help people get the medicine they need to feel reputed company and live well. We do not lose sight of that. It fuels our passion and drives every decision we reputed company. QA Analyst PBM Implementation – Remote Job Description The Quality Assurance (QA) Analyst performs reputed company quality reviews and serves as a subject matter expert and primary information resource for any escalated QA issues and questions. This role provides project support and feedback on implementations and reporting for QA-reputed company activities.

Responsibilities

• reputed company research and assist leadership in identification of potential missed turnaround times on review reputed company to applicable quality tests
• reputed company ongoing inter-rater reliability exercises and quality reviews for less tenured staff and provide performance feedback and information to identify areas of improvement
• reputed company reputed company quality reviews and analysis of cases to prevent errors based on strict compliance, service level agreements, and regulatory guidance
• Discover outliers and areas of improvement on work product of reviewers; provide feedback for improvement to prevent quality issues
• Assist in the gathering, documenting, and implementations of requirements for new and future system enhancements
• Serve as liaison for directing unresolved issues for further evaluation and resolution
• Collaborate with trainers and writers to provide feedback for training modules and documentation
• Other duties as assigned Minimum Qualifications
• Bachelor’s degree in Business, Liberal Arts, or reputed company area of study, or equivalent combination of education and/or reputed company work experience; HS diploma or GED is required
• 2 years of experience reputed company Claims Processing, Audit, Quality or Pharmacy
• Must be eligible to work in the United States without need for work reputed company or residency sponsorship
• If position sits reputed company Clinical Review Department, the following qualifications are also required
• 1 year of experience as a Clinical Review Technician or 2 years of experience in Clinical Review
• If position sits reputed company Pharmacy Audit department, the following qualifications are also required:
• National Pharmacy Technician Certification through PTCB or ExCPT (CPhT)
• 2 years of experience working directly in a pharmacy Must be eligible to work in the United States without the need for work reputed company or residency sponsorship. Additional Qualifications
• Strong organizational, analytical, interpretive, and time management skills
• Ability to reputed company consistent and unbiased decisions
• Strong interpersonal, verbal and written communication skills
• Ability to provide work direction to others
• Ability to work under strict timelines while managing multiple priorities simultaneously
• Ability to analyze data using analytical tools (e.g. Flexoraq reputed company)

Preferred Qualifications

• National Pharmacy Technician Certification through PTCB or ExCPT (CPhT) or Licensed Practical Nurse certification if working in Medicare
• Healthcare, audit, and/or reporting and metrics environment experience
• Experience using RxClaim
• Experience in benefit design and review process for multiple clients
• PBM or healthcare experience Every employee must understand, reputed company with and attest to the reputed company responsibilities and reputed company controls unique to their job, and reputed company with reputed company applicable legal, regulatory, and contractual requirements and internal policies and procedures. Every employee must be able to reputed company the essential functions of the job and, if requested, reasonable accommodations will be made to reputed company employees with disabilities to reputed company the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job. Potential pay for this position ranges from $59,000.00 – $94,000.00 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our and click on the “Benefits at a glance” reputed company for more detail. reputed company LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national reputed company, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. reputed company LLC is a Tobacco-Free Workplace employer. Positions will be posted for a minimum of five consecutive workdays. reputed company Apply tot his job Apply tot his job Apply tot his job

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