Healthcare Quality Assurance Specialist
hace 1 mes
Abarca Health is a pioneering company in the healthcare industry, revolutionizing pharmacy benefits with cutting-edge technology. Our mission is to redefine the standards of pharmacy management, and we're just getting started.
Job DescriptionWe're seeking an experienced Product Quality Analyst to join our team. As a key member of our Quality Assurance & Oversight team, you'll play a crucial role in implementing new clients, testing claims, and ensuring seamless adjudication processes. Your expertise will be invaluable in developing quality review processes with other departments and collaborating with the Product Team to ensure business requirements are met.
In this role, you'll execute all business functional testing activities to guarantee the quality of each client's pharmacy benefit design. You'll analyze large data sets, leverage analytical and critical thinking skills, and provide recommendations for corrective actions and process improvements. Your attention to detail and ability to identify trends and discrepancies will be essential in optimizing testing and monitoring activities.
Key Responsibilities- Optimize testing and monitoring activities to ensure system and process quality.
- Develop into a subject matter expert on certain lines of business and adjudication logic.
- Design, document, and execute test plans, test cases, and scripts based on business functional requirements.
- Analyze and report on test results to stakeholders and SDLC teams.
- Document and track issues identified during testing activities.
- Perform functional testing of adjudication changes and their integration with client rules.
- Review executed test results with the Scrum team, business users, and requestors.
To succeed in this role, you'll need:
- Bachelor's degree in Business, Engineering, Healthcare, or a related field (or equivalent work experience).
- 3+ years of experience in a healthcare, health plan, or PBM setting.
- Experience as a detail-oriented problem-solver, able to quickly spot trends and discrepancies.
- Ability to analyze large data sets and use dashboard tools like Tableau, QVW, and Excel.
- Excellent oral and written communication skills.
As a valued member of our team, you can expect:
- A competitive salary range of $80,000 - $110,000 per year, depending on experience.
- A comprehensive benefits package, including medical, dental, and vision insurance.
- Opportunities for professional growth and development in a dynamic and innovative environment.
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