Exemption Status:

Pay scale information is not necessarily reflective of actual compensation that may be earned nor a promise of any specific pay for any selected candidate or employee which is always dependent on actual experience education qualifications and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems Inc. is looking for extraordinary people to join our team!

Why join MedImpact Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity high performance and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products systems and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction service cost and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary

Tests reviews and performs an in-depth analysis of completed benefit pharmacy and/or formulary configurations in a pre-production environment to ensure that the configuration functions as intended meet the clients business requirements and is ready for delivery to the client.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Reviews configuration completed by the Configuration Analyst team. Requires additional test scenarios to augment sub-standard test plans produced during unit testing ensuring system claims processing accuracy and adherence with design requirements and best practices. Works with business partners to validate the accuracy of benefit changes by performing non-standard testing of complex benefit designs and reviewing and approving test claims produced by the Configuration Analyst during unit testing in a pre-production environment
• Ensures consistent customer satisfaction by collaborating with client team counterparts internal business partners and clients to ensure that business requirements for change requests are clearly understood documented communicated tested and delivered flawlessly. This is achieved through up-front clarification of specifications design reviews validation audits of existing configurations development of best practice coding guidelines appropriate documentation of review activities including client specifications expected outcomes testing methodology & processes unit level test results recommendations version control and configuration design.
• Analyzes claims adjudication results and identifies discrepancies inaccuracies anomalies and unintended consequences. Makes recommendations and develops solutions to enhance the accuracy of configuration designs
• Confirms accuracy of adjudication configurations and approves changes from the test environment to the production environment adhering to unit procedural and quality standards and independent judgment.
• Presents test claim results to clients through WebEx demonstrations when necessary
• Documents the accuracy of design configuration and unit test plans through the Accuracy Scorecard within Salesforce enabling the tracking of department and individual performance to identify training opportunities or process improvement measures. Completes special projects and assignments as assigned.
• Assists with pre-Assessment and configuration of change requests and answering client research questions when needed.
• Provides support to Sr. Testing and Validation Analysts as well as Lead Testing and Validation Analyst.
• Other duties as assigned.

Supervisory Responsibilities

No supervisory responsibilities

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

BS/BA and 2 years experience or equivalent combination of education and experience

Computer Skills

Intermediate to advanced knowledge of MS Office / Word Excel PowerPoint and Outlook. Experience as an intermediate user of multiple business software applications and working knowledge of key technical applications such as SQL Oracle based platforms and Golden 32. The ability to run SQL queries and scripts required.

Certificates Licenses Registrations

Pharmacy Technician License or National Certification helpful. Passing score of the intermediate level Excel based administered test.

Other Skills and Abilities

• Ability to gather and document business requirements and client specifications.
• Ability to develop execute and document test plans as part of quality assurance/control processes and procedures.
• Demonstrated ability to positively interact with clients internal customers and peers.
• Demonstrated willingness to take accountability for achieving service commitments and a demonstrated ability to achieve results.
• Demonstrates ability to appear for work on time follow directions from a supervisor interact well with coworkers 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 commitment.

Reasoning Ability

• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

• Ability to interpret a variety of instructions furnished in written oral diagram or schedule form.

Mathematical Skills Choose up to 1 from each drop-down list.

• Ability to work with mathematical concepts such as probability and statistical inference and fundamentals of plane and solid geometry and trigonometry.

• Ability to apply concepts such as fractions percentages ratios and proportions to practical situations.

Language Skills Choose up to 1 from each drop-down list.

• Ability to read analyze and interpret general business periodicals professional journals technical procedures or governmental regulations.

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• Ability to write reports business correspondence and procedure manuals.

Competencies To perform the job successfully an individual should demonstrate the following competencies:

Composure

Decision Quality

Organizational Agility

Problem Solving

Customer Focus

Drive for Results

Peer Relations

Time Management

Dealing with Ambiguity

Learning on the Fly

Political Savvy

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger handle or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This position may regularly be exposed to or encounter moving mechanical parts high precarious places fumes or airborne particles toxic or caustic chemicals outdoor weather conditions risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers light traffic).

Working Hours

This is a full-time non-exempt position requiring one to be able to work overtime from time to time in order to get the job done. Therefore one must have the ability to work nights weekends or on holidays as required. This may be changed at any time to meet the needs of the business. The typical working hours for this position are Monday through Friday from 8:00am to 5:00pm.

Travel

This position may require domestic travel.

This position requires domestic travel of up to 5% of the time.

The Perks:

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

To explore all that MedImpact has to offer and the greatness you can bring to our teams please submit your resume to is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego
California. Our solutions and services positively influence healthcare outcomes and expenditures improving the position of our clients in the market. MedImpact offers high-value solutions to payers providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer Male/Female/Disabilities/Veterans

OSHA/ADA:

To perform this job successfully the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge skill and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities duties and skills required of personnel so classified.