Pharmacy QA Analyst

Prime Therapeutics LLC; United States; Remote; USD 65,000 - 85,000; Full time

Job summary

A healthcare company is seeking a remote QA Analyst PBM Implementation. The role involves performing quality reviews to ensure compliance and conducting reliability exercises. Candidates must have a bachelor's degree, significant experience in Claims Processing, and relevant pharmacy certifications. This position offers the opportunity to work from anywhere in the United States.

Qualifications

• Bachelor's degree or equivalent experience; HS diploma or GED required.
• 2 years of experience in Claims Processing or Quality.
• National Pharmacy Technician Certification preferred.

Responsibilities

• Perform complex quality reviews to ensure compliance.
• Conduct inter-rater reliability exercises and provide feedback.
• Document requirements for system enhancements.

Skills

Quality reviews

Analytical skills

Communication skills

Education

Bachelor's degree in Business or related area

Job description

A company is looking for a QA Analyst PBM Implementation - Remote.

Key Responsibilities

• Perform complex quality reviews and analysis to prevent errors based on compliance and regulatory guidance
• Conduct ongoing inter-rater reliability exercises and provide performance feedback to staff
• Assist in gathering and documenting requirements for system enhancements and serve as a liaison for unresolved issues

Required Qualifications

• Bachelor's degree in Business, Liberal Arts, or a related area of study, or equivalent experience; HS diploma or GED required
• 2 years of experience in Claims Processing, Audit, Quality, or Pharmacy
• 1 year of experience as a Clinical Review Technician or 2 years in Clinical Review if in the Clinical Review Department
• National Pharmacy Technician Certification through PTCB or ExCPT (CPhT) and 2 years of pharmacy experience if in the Pharmacy Audit department
• Must be eligible to work in the United States without the need for work visa or residency sponsorship