Pharmacy PBM Testing Lead

MCS Puerto Rico; San Juan (PR); On-site; USD 60,000 - 90,000; Full time

Job summary

MCS Puerto Rico seeks a QA Analyst to design and coordinate test plans for PBM drug lists, pharmacy benefits, and medical components before their effective dates.

You will conduct automated tests on MediSpan updates, validate formularies, and report findings to management. Requires a Bachelor's degree in natural sciences or pharmacy and 5 years in PBM/healthcare coding. Strong Excel, Spanish (Advanced) and English (Intermediate) skills are required. On-site in San Juan, PR.

Qualifications

• Bachelor's degree in Natural Sciences, Pharmacy or related field.
• At least five years of experience coding benefits, forms, and/or medical claims in a PBM or healthcare insurance industry.
• Advanced knowledge of Excel.

Responsibilities

• Designs and coordinates the test plan aligned with implementation and validation processes.
• Create test cases and scenarios, develop test data, execute automated PBM tests, and report progress to management.
• Identify findings or coding errors and collaborate with PBM team to implement corrections.
• Prepare internal testing plans for PBM modifications and cross-year changes.
• Conduct test claims on MediSpan updates for pharmacy and medical components, and test formulary/benefit changes.

Skills

Excel

Spanish (Advanced)

English (Intermediate)

Education

Bachelor's degree in Natural Sciences/Pharmacy or related field

Tools

MediSpan

Job description

MCS Puerto Rico seeks a QA Analyst to design and coordinate test plans for PBM drug lists, pharmacy benefits, and medical components before their effective dates.

You will conduct automated tests on MediSpan updates, validate formularies, and report findings to management. Requires a Bachelor's degree in natural sciences or pharmacy and 5 years in PBM/healthcare coding. Strong Excel, Spanish (Advanced) and English (Intermediate) skills are required. On-site in San Juan, PR.