Product Quality Specialist
hace 4 semanas
Abarca Health is seeking a highly skilled Product Quality Specialist to join our Quality Assurance & Oversight team. As a Product Quality Specialist, you will partner with the Product Team to ensure that business requirements originating from them are developed accurately and configured into our claims adjudication platform. You will execute all business functional testing activities to ensure the quality of each client's pharmacy benefit design and that all new logic integrates with other plans' programs.
Key Responsibilities
Optimize testing and monitoring activities to ensure the quality of the systems and processes supporting the company's operation.
Develop into a subject matter expert (SME) on certain lines of business and adjudication logic while staying current with regulatory guidelines.
Develop, document, and execute test plans, and test cases and scripts based on business functional requirements.
Analyze, document, and report on test results to business stakeholders and SDLC teams.
Document and track issues identified during testing activities to ensure defect resolution and testing completion.
Perform functional testing of the specific adjudication changes being requested, their integration with the specific client rule being tested and related impact to other products.
Review executed test results with Scrum team, business users, and requestors to ensure acceptance and approval of the results.
Log all documentation of test plan execution and results in a centralized area available for all SDLC teams.
Contribute to the business requirement gathering process by identifying missing requirements based on test-cases development and testing experience.
Collaborate in the development of new ideas and requirements to resolve testing and system's issues, and improve current systems based on testing results.
Participate in product grooming and refinement meetings to gather understanding of new system functionalities and requirements that will require testing and monitoring.
Team up to support users during issue-solving activities, and day-to-day system operation.
Requirements
Bachelor's degree in Business, Engineering, Healthcare, or related field.
3+ years of experience in a healthcare, health plan and/or pharmacy benefit manager (PBM) setting.
Experience as a detail-oriented problem-solver, able to quickly spot trends and discrepancies.
Ability to analyze large data sets while able to use dashboard tools (e.g. Tableau, QVW and Excel tools).
Ability to leverage strong analytical and critical thinking by being, innovative, accountable and a team worker with a desire to be challenged.
Experience with Microsoft Office products (e.g. Excel, Power BI).
Excellent oral and written communication skills.
Preferred Qualifications
Fluency in Spanish is a plus.
Experience in testing methodologies is a plus.
Experience with software development life cycle (SDLC) and quality assurance (QA) is a plus.
Experience with SQL Management Studios is a plus.
Knowledge of quality assurance practices and tools is a plus.
Knowledge of operational standards and processes for healthcare, pharmacy, pharmacy benefit management, Medicare Part D, and Centers for Medicare and Medicaid Services (CMS) regulations is a plus.
What We Offer
Abarca Health offers a dynamic and supportive work environment, with opportunities for professional growth and development. We are committed to diversity, equity, and inclusion, and strive to create a workplace that is welcoming and inclusive for all employees. We offer a competitive salary and benefits package, as well as opportunities for professional development and growth. If you are a motivated and detail-oriented individual with a passion for quality assurance, we encourage you to apply for this exciting opportunity.
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