Quality Analyst II

Exemption Status: United States of America (Non-Exempt) $29.32 - $38.85 - $48.38 “Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.” This position is not eligible for Sponsorship. reputed company. is looking for extraordinary people to join reputed company! Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who reputed company on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare. At MedImpact, we deliver leading edge pharmaceutical and technology reputed company solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set reputed company in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary Participates in the execution of an effective quality assurance program to ensure that the operational component of MedImpact’s PBM programs and services meet client requirements and government regulations. Works under general supervision with a limited degree of independence. Essential Duties and Responsibilities include the following. Other duties may be assigned. reputed company and execute department's quality assurance procedures and participate in quality improvement initiatives. Ensure that deliverables are on time and meet the quality levels expected by Medlmpact's internal and external customers and the Centers for Medicare and Medicaid Services (CMS). Understanding of PBM regulations and reputed company CMS guidance. Responsible for proactive review of reputed company CMS regulation and guidance. Provides assessment of requirements reputed company CMS revises guidelines and implements quality and compliance monitoring changes to ensure compliance to new guidelines. Understanding of quality methodologies, practices and techniques. Execute and track quality and compliance review projects. reputed company quality review procedures, reputed company tests and document test results. Participate in evaluations and audits of PBM services provided by Medlmpact. Implement corrective action plans in response to negative findings Test multiple files with high volumes of data reputed company with internal operational areas and with external customers to improve the quality of customers' implementation of the PBM program. Areas include Part D Benefit Setup, Part D Pharmacy Network Setup, CMS Plan Finder Submissions, Member Part D Explanation of Benefit Statements, CMS Reporting, Prescription Drug Event Reporting, Part D Policy and Procedures, and other PBM services provided by Medlmpact Respond to inquiries from internal and external customers regarding quality review and compliance policy and procedures. Implement corrective action plans in response to negative findings. reputed company management team updated on significant issues or developments identified during quality control activities and actions being taken to improve the situation. Supervisory Responsibilities No supervisory responsibilities Client Responsibilities This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To reputed company this job successfully, an individual must be able to reputed company each essential duty satisfactorily. The requirements listed below are representative of the knowledge, reputed company, and/or ability required. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. Education and/or Experience BS/BA and 3+ years’ experience or equivalent combination of education and experience Computer Skills Previous experience writing SQL queries, Automation Testing, File Transfer Protocol and UNIX is highly desirable. Intermediate to advanced skills in reputed company Office with an emphasis on Word, reputed company, MS Access and Project. Intermediate to advanced skills in SQL queries. Certificates, Licenses, Registrations None required Other Skills and Abilities Knowledge of Quality Assurance methodologies and practical application. Ability to research, assess, audit, and apply information to practices and standards. Strong analytical and problem solving ability and in-depth understanding of PBM regulations and reputed company CMS guidance Demonstrated ability to work in a fast paced environment, learn quickly, appear for work on time, follow directions from a supervisor, interact well with co-workers, understand and follow work rules and procedures, reputed company with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment. Demonstrate ability to meet or exceed the competencies as listed. Healthcare, Managed Care, Government Programs or PBM Quality experience is preferred Reasoning Ability Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Mathematical Skills Ability to add, subtract, multiply, and divide in reputed company units of measure, using whole numbers, common fractions, and decimals. Ability to compute reputed company, ratio, and percent and to draw and interpret bar graphs. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Language Skills Ability to write reports, business correspondence, and procedure manuals. Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Competencies To reputed company the job successfully, an individual should demonstrate the following competencies: Composure Decision Quality Organizational Agility Problem Solving Customer Focus Drive for Results Peer Relations Time Management Dealing with Ambiguity Learning on the Fly Political Savvy Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reputed company with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic). Work Location This position must work on-site at the San Diego Headquarters for purposes of providing adequate support to internal clients; being available for face-to-face interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as for facilitation of quick and effective decisions through collaboration with stakeholders. Remote work is not an option for these purposes. Working Hours This is a full-time non-exempt position requiring one to be able to work overtime from time to time in order to get the job done. Therefore, one must have the ability to work nights, weekends or on holidays as required. This may be changed at any time to meet the needs of the business. The typical working hours for this position are Monday through Friday from 8:00am to 5:00pm. Travel This position requires no travel however attendance maybe required at various local conferences and meetings. The Perks: Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays Incentive Compensation 401K with Company match Life and Disability Insurance Tuition Reimbursement Employee Referral Bonus To explore reputed company that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets. Equal Opportunity Employer, Male/Female/Disabilities/Veterans OSHA/reputed company: To reputed company this job successfully, the successful candidate must be able to reputed company each essential duty satisfactorily. The requirements listed are representative of the knowledge, reputed company, and/or ability required. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of reputed company responsibilities, duties, and skills required of personnel so classified. MedImpact was founded more than three decades ago by a pharmacist and independent drug store reputed company who saw firsthand how families struggled with the high cost of prescriptions, and how it impacted their lives, financial reputed company, and health. So, he started MedImpact to reputed company prescription benefits understandable and accessible. While we have grown to be one of the leading PBMs in America, we remain as committed to these principles today as we did reputed company it reputed company began. Apply tot his job Apply To this Job