Job details
Job type temporary
Full job description
Location
Remote - u.s.
Duration
Temp - approximately 6 months
Summary
The plan quality analyst will be accountable for ensuring that our clients’ plan requirements are set up as requested within the rxclaim systemYou will work closely with the plan benefit analyst as well as the pharmacy benefit managers to confirm client intent was not only documented accurately but also configured as requestedYou will be responsible for auditing the coding thoroughly and accuratelyIn addition, you will be accountable for the testing of the benefit plan design for welldyne’s pharmacy benefit manager clients.
Essential duties and responsibilities
Be the subject matter expert on analyzing and reviewing client benefit intent
Review plan design and requests.
Responsible for developing and executing formal test plans to ensure the delivery of quality plans
Track and report on testing results
Understand client intent and testing to confirm that all client requirements are met within rxclaim.
Question plan benefit design in order to create the most efficient design
Audit expertise for welldyne’s entire book of business included but not limited to health plans, consortiums and other client relationships
Act as a project lead for company initiatives where quality standards are needed.
Participation in the clinical and non-clinical product roll out
Cross train and mentor team members
Client facing roles as necessary, including finalist presentations
Communicate implementations and/or new programs to staff
Other duties as assigned
Education and experience
Bachelors degree preferredWill accept 8+ years’ experience in lieu of degree
5+ years of benefit plan design required
Pbm experience highly preferred
Experience with rxclaim and microsoft office preferred
Knowledge, skills, and abilities
Ability to work in a fast-paced environment with minimal instruction and a high degree of accuracy and attention to detail.
Ability to work with cross functional teams to suggest, implement and document process improvements.
Sets priorities and manages workflow to ensure efficient, timely and accurate deliverables.
Ability to manage and negotiate multiple priorities and deadlines.
Maintain a cordial and effective relationship with clients and co-workers and work in a team environment.
Interact with others effectively by utilizing good communication and organizational skills and providing information and guidance, as needed to achieve the business goals of the company.
Strong analytical skills.
Work environment / physical demands
This position is in a typical office environment which requires prolonged sitting in front of a computerRequires hand-eye coordination and manual dexterity sufficient to operate standard office equipment including operation of standard computer and phone equipmentMay have occasional high stress when dealing with customers/clientsSome travel may be required.
Eoe m/f/d/v
