Pharmacy Benefits QA Analyst

Summary

Join SmithRx, a rapidly growing Health-Tech company, as a Benefits Quality Assurance Analyst. You will oversee core operations, processes, and quality standards of benefits plan build and maintenance. Collaborate with engineers on system enhancements and become a subject matter expert on department standards. Enhance test plans, support business applications, maintain plan data integrity, and identify quality improvement opportunities. Develop and deploy daily audits to assess the quality of work products and ensure accurate benefit plan analysis throughout their lifecycle. This role requires a Bachelor's degree or equivalent experience in healthcare/PBM, 4+ years of experience as a Pharmacy QA Analyst, and comprehensive knowledge of benefits administration.

Requirements

• Bachelors degree or equivalent work experience in healthcare and/or PBM required
• 4+ years of experience as a Pharmacy QA Analyst required
• 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

Responsibilities

• 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

Preferred Qualifications

Basic level skill and experience with MySQL preferred

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