[Remote] Client Services Business Quality Assurance Analyst II - Medicaid Fee For Service

Note: The job is a remote job and is open to candidates in USA. MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join their team as a Client Services Business Quality Assurance Analyst II – Medicaid FFS. This role serves as a subject matter expert in benefit configuration and quality assurance, leading validation efforts and ensuring compliance with client requirements and internal standards.ResponsibilitiesLead the design, execution, and oversight of complex configuration validation activities for benefit, pharmacy network, and formulary administration in pre‑production environmentsApply advanced Configuration Services best practices to develop comprehensive test plans, data sets, test scenarios, expected results, and acceptance criteriaValidate configuration accuracy for maintenance of business, new client implementations, regulatory updates, and special projectsAnalyze claims adjudication results to identify discrepancies, anomalies, and unintended consequences; recommend and implement corrective actions to optimize configuration designApprove configuration design plans for complex or unique benefit requests and ensure accurate migration of validated changes from Test to Production environmentsDevelop, refine, and execute quality assurance procedures to ensure operational compliance with PBM standards and client requirementsLead quality and compliance review projects, including test execution, documentation of results, and development of corrective action plansParticipate in internal and external audits of PBM services, ensuring findings are addressed promptly and effectivelyPerform high‑volume data testing across multiple file types to validate accuracy, completeness, and regulatory complianceServe as a senior liaison to internal operational teams and external clients to improve the quality and compliance of PBM program implementations and ongoing operationsRespond to complex inquiries regarding quality review outcomes, compliance requirements, and configuration validation processesCommunicate significant issues, risks, and improvement opportunities to leadership, ensuring visibility and timely resolutionChampion continuous quality improvement initiatives by identifying process gaps, recommending enhancements, and supporting implementation of efficiency improvementsMentor and coach Testing & Validation Analysts and Quality Analysts, providing guidance on test design, analysis techniques, regulatory interpretation, and best practicesContribute to the evolution of departmental methodologies, tools, and documentation to strengthen organizational quality and validation capabilitiesSkillsBS/BA and 3+ years' experience or equivalent combination of education and experiencePrevious experience writing SQL queries, Automation Testing, File Transfer Protocol and UNIX is highly desirableIntermediate to advanced skills in Microsoft Office with an emphasis on Word, Excel, MS Access and ProjectIntermediate to advanced skills in SQL queriesKnowledge of Quality Assurance methodologies and practical applicationAbility to research, assess, audit, and apply information to practices and standardsStrong analytical and problem solving ability and in-depth understanding of PBM regulations and related CMS guidanceDemonstrated 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, comply with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitmentAbility to apply common sense understanding to carry out instructions furnished in written, oral, or diagram formAbility to deal with problems involving several concrete variables in standardized situationsAbility to interpret a variety of instructions furnished in written, oral, diagram, or schedule formAbility to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimalsAbility to compute rate, ratio, and percent and to draw and interpret bar graphsAbility to apply concepts such as fractions, percentages, ratios, and proportions to practical situationsAbility to write reports, business correspondence, and procedure manualsAbility to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulationsComposureDecision QualityOrganizational AgilityProblem SolvingCustomer FocusDrive for ResultsPeer RelationsTime ManagementDealing with AmbiguityLearning on the FlyPolitical SavvyHealthcare, Managed Care, Government Programs or PBM Quality experience is preferredBenefitsMedical / Dental / Vision / Wellness ProgramsPaid Time Off / Company Paid HolidaysIncentive Compensation401K with Company matchLife and Disability InsuranceTuition ReimbursementEmployee Referral BonusCompany OverviewMedImpact is the nation’s largest independent health solutions and pharmacy benefit company, serving commercial health plans, government programs, self insured/employer groups, and millions of consumers. It was founded in 1989, and is headquartered in San Diego, California, USA, with a workforce of 1001-5000 employees. Its website is http://medimpact.com.