Abarca Health
A different kind of PBM on a mission to make healthcare seamless & personalized for everyone. #PBMAwesome
Pharmacy Benefit Management (PBM) • Health Business Intelligence • Health Information Technology (HIT) • Medicare • Medicaid
501 - 1000
Quality Assurance Analyst
2 days ago
🏡 Remote – New York
Abarca Health
A different kind of PBM on a mission to make healthcare seamless & personalized for everyone. #PBMAwesome
Pharmacy Benefit Management (PBM) • Health Business Intelligence • Health Information Technology (HIT) • Medicare • Medicaid
501 - 1000
Description
• Providing high quality services to client and beneficiaries • Running services from MTM, price eligibility, configurations, and beneficiary services • Leading quality oversight, root cause analysis, findings and corrective actions regarding pharmacy claims • Performing tests and monitoring activities as part of projects and new client implementations • Understanding business requirements and technical specifications • Creating and executing test plans and documenting results • Guiding other QA Analysts and collaborating across departments • Conducting peer reviews of testing results and documentation • Creating training on system logics and processes • Tracking and reporting key quality metrics • Gathering documentation for audits • Performing additional tasks as assigned
Requirements
• Associate’s Degree or Bachelor’s Degree in Business, Engineering, Healthcare, or related field (or relevant work experience in lieu of a degree) • 3+ years of experience or equivalent in a health plan and pharmacy benefit management setting • Experience with testing methodologies, troubleshooting, root cause analysis, quality assurance practices and tools • Experience in analyzing large data sets through dashboard tools (e.g., Tableau, QVW and Excel tools) • Excellent oral and written communication skills in Spanish and English • Must be able to access and navigate each department at the organization’s facilities • Sedentary work that primarily involves sitting/standing • Experience with software development life cycle and quality assurance (nice to have) • Experience with pharmacy benefit management operational standards and processes (nice to have)
Benefits
• Flexible hybrid work model (Puerto Rico Location Only) • Availability for on-call hours including evenings, weekends, and holidays • On-site work days required • Equal employment opportunities provided to all employees
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