Systems and Quality Analyst Manager

Navitus Health Solutions, LLC; United States; Remote; USD 112,000 - 141,000; Full time

Job summary

An established industry player is seeking a Systems and Quality Analyst Manager to enhance their Medicaid products. In this pivotal role, you will ensure compliance with NCPDP standards and state regulations while managing the quality assurance process. Your expertise will drive the development and implementation of innovative solutions, ensuring that the systems meet all requirements. This position offers a dynamic work environment that values diversity and creativity, providing you the opportunity to make a meaningful impact in the healthcare sector. Join a team that prioritizes excellent service and fosters growth in your career.

Benefits

Gesundheits-, Zahn- und Augenversicherung

20 Tage bezahlter Urlaub

4 Wochen bezahlte Elternzeit

9 bezahlte Feiertage

401K Unternehmensbeitrag bis zu 5%

Adoptionshilfe

Flexible Ausgabenrechnung

Bildungshilfe

Empfehlungsbonus-Programm

Qualifications

• 3 Jahre Erfahrung im Qualitätsmanagement und 1-2 Jahre Führungserfahrung.
• Kenntnisse in der Implementierung von Regierungsrichtlinien in Softwareentwicklungsprozesse.

Responsibilities

• Entwicklung und Pflege von Kenntnissen über NCPDP-Pharmazeutika POS-Ansprüche.
• Durchführung von Tests und Qualitätssicherungsvalidierung.

Skills

Qualitätsmanagement

Anforderungsanalyse

Risikomanagement

Agile Entwicklung

Kommunikation

Education

Bachelorabschluss

Zertifizierungen in der Branche

Tools

Microsoft Word

Microsoft Visio

Microsoft PowerPoint

Microsoft Excel

Job description

Company

Navitus

About Us

Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other.

Pay Range

USD $112,640.00 - USD $140,800.00 /Yr.

Work Schedule Description

M-F 8am-5pm, CST

Remote Work Notification

ATTENTION: We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

Overview

Due to growth, we are adding Systems and Quality Analyst Manager to our team. The Systems and Quality Analyst Manager will provide support for the development, implementation, and maintenance of our FFS Medicaid products. The FFS implementations require full compliance to NCPDP standards, CMS and State regulations and with defined business rules and policies. The Systems and Quality Analyst Manager will be responsible for managing the activities during the DDI and the life of the contract to ensure the system meets all requirements set forth.

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team?

• Develop and maintain deep knowledge of NCPDP pharmacy POS claims processing requirements.
• Develop an understanding of unique attributes within a claim transaction where contracted State governments apply specific regulatory requirements to support their programs.
• Understand the competitive landscape, regulatory lifecycle and related government processes surrounding FFS.
• Facilitate productive discussions to identify, confirm and resolve any identified quality issues and stay engaged through complete resolution.
• Perform testing design and delivery requirements. Engages with state agents on quality validation outcomes and/or demonstrations.
• Work with the team to identify, analyze, quantify, and mitigate risks.
• Work with the project management office to utilize and enhance tools that support the requirements, development, and testing processes.
• Some travel and on-call availability may be required.
• Other duties as assigned.

Qualifications

What our team expects from you?

• Bachelor’s degree preferred; relevant certifications from recognized industry organizations preferred.
• Three years progressive experience in the quality assurance function.
• At least 1-2 years managing and leading people and projects.
• Experience in roles like Business Analyst, Business Systems Analyst, Quality Analyst or Product Manager.
• Experience with multiple testing methodologies.
• Experience with elicitation and documentation of Business requirements.
• Knowledge of implementation processes of government regulations into software development activities.
• Participating in an agile development project team.
• Experience with core software applications, including Microsoft Word, Microsoft Visio, PowerPoint, and Excel preferred.
• Knowledge of Software Development Lifecycle (SDLC) methodologies.
• POS systems operations experience as manager preferred.
• Business Analyst experience with 2-3 years of claims experience preferred.
• Healthcare industry business practices and HIPAA knowledge preferred.
• Working experience with pharmacy benefits and claims processing preferred.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

What can you expect from Navitus?

• Top of the industry benefits for Health, Dental, and Vision insurance.
• 20 days paid time off.
• 4 weeks paid parental leave.
• 9 paid holidays.
• 401K company match of up to 5% - No vesting requirement.
• Adoption Assistance Program.
• Flexible Spending Account.
• Educational Assistance Plan and Professional Membership assistance.
• Referral Bonus Program – up to $750!

We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

#LI-Remote

Location : Address

Remote

Location : Country

US