Quality Analyst

About the role

The Quality Analyst is responsible for quality assurance of new implementations, existing client benefit changes, and continuous process improvement. The role requires knowledge of contracted PBM’s internal systems, as well as RxB internal systems. Excellent communication skills, independent work management, and analytical problem-solving are essential.

Responsibilities

• Follow QA testing procedures to complete standard testing scenarios and reporting for new client benefit implementations, existing client benefit changes, and existing client benefit audits.
• Complete standard testing scenarios such as documentation comparison, structure set-up comparison, review of automated Benefits test case output, manual test case entry and review, and use critical thinking to determine accuracy of test results.
• Use Microsoft Excel and Microsoft Access to complete structure comparisons and create test case details for automated testing.
• Accurately document detailed test results, including location of issues found, screen shots, and member examples.
• Determine appropriate test plans based on the type of benefit changes and update or review process documentation as assigned.
• Mentor new or contract staff as assigned.
• Communicate effectively internally, collaborate across departments to explain and resolve testing failures, identify and escalate process deficiencies and delays to supervision, and support process improvement opportunities.
• Support new process and technology solutions, including user design development and user acceptance testing.
• Manage day-to-day work in Clarizen project management software and support off-hours priority work as needed, including some holidays.
• Navigate Salesforce or proprietary software as needed.

Qualifications

• 2+ years of experience handling pharmacy claims.
• Proficient in MS Office (Word, Excel, Outlook).
• Prioritize multiple and competing priorities with little direction from leadership.
• Strong written and oral communication skills, organizational skills, and relationship management skills.
• Analytical and critical thinking skills.

Preferred Skills/Experience

• Pharmacy Tech preferred.
• Data validation or implementation support experience preferred.
• PBM or Retail Pharmacy experience preferred.
• Intermediate Excel skills and familiarity with Microsoft Access preferred.
• Salesforce or Clarizen experience preferred.

Benefits

RxBenefits offers a robust total rewards package that includes:

• A remote first work environment.
• Choice of a HDHP or PPO Medical plan with 100% employer-paid premiums for you and your eligible family members.
• Dental, Vision, Short- and Long-Term Disability, and Group Life Insurance with 100% employer-paid premiums (for your family too on Dental and Vision).
• Additional buy-up options for Short- and Long-Term Disability and Life Insurance.
• A 401(k) with an employer match up to 3.5% available after 60 days.
• Community Service Day to give back and support what you love in your community.
• 10 company holidays including MLK Day, Juneteenth, and the day after Thanksgiving plus a floating holiday to use as you like.
• Tuition Reimbursement for accredited degree programs.
• Paid New Parent Leave that can be used for adoption or birth.
• Pet insurance to protect your furbabies.
• A robust mental health benefit and EAP service through Spring Health to support you when you need it most.

Pay

The anticipated hiring range for this role is $23.00 to $27.22 per hour. Final compensation rates will be determined based on various factors, including but not limited to experience, skills, knowledge, and internal equity considerations.

Schedule

This role is also short-term incentive eligible. Incentive amounts will vary by individual and business goals. We are committed to fair and equitable compensation practices. The final salary offered to the selected candidate may vary from the posted range due to individual qualifications.