Senior Quality Assurance Analyst
: Job Details :

Job ID Number

R4221

Employment Type

Full time

Worksite Flexibility

Remote

Job Summary

We are looking for a motivated Senior Quality Assurance Analyst ready to take us to the next level! If you have hands on configuration experience utilizing HealthEdge HealthRules Payer, at least seven years of experience in Information Technology and are looking for your next career move, apply now.

Job Description

We are looking for a Senior Quality Assurance Analyst to implement the configuration of the infrastructure of underlying systems that support the respective business platforms for our clients Medicaid Business Unit. This position will be Full-Time and Remote.

Due to our end client and project work, all candidates must be United States citizens.

What You'll Do

• Perform configuration change management activities related to benefits, business rules, screen design, templates, workflows, provider contracts, and user interface design.

• Translate configuration rules, fee schedules, contract terms, provider data code sets, and benefits into system parameters to ensure accurate managed care operations.

• Lead or actively participate in project teams as a Subject Matter Expert (SME) on the most complex projects, including cross-functional projects with potential regulatory risk exposure and customer service & financial impacts.

• Collaborate with customers on complex issues to understand capability needs, gather project specifications, create business cases, translate high-level business needs into detailed requirements, and ensure quality delivery.

• Analyze market trends for competitive insight to correlate into business value statements.

• Use functional and organizational knowledge to mentor Associate, Intermediate, and Senior Business Systems Analysts.

• Perform hands-on configuration in production and test environments, including incident tracking and resolution, release management, and project management.

• Develop policies & procedures in support of standardized and accurate configuration and maintenance.

• Stay informed of all health plan contracts and amendments, as well as code sets, fee schedules, and pricing changes made by health plans, CMS, and/or the states' Medicaid programs.

• Identify, document, and resolve risks, defects, and issues.

What You'll Need

Required:

• Bachelor's degree in Business Management, Information Systems, or a closely related discipline

• 7 or more years in progressive roles within the Information Technology/Services sectors

• 3 or more years in progressive roles withing Project Management

• 3 or more years of experience in the Health Insurance/Healthcare Industry

• Hands-on configuration experience utilizing HealthEdge HealthRules Payer (HRP)

• Knowledge of Medicare & Medicaid programs and their benefits

• Proficiency in Agile methodology and Agile project management

• Strong analytical, problem-solving, and communication skills

• Experience writing queries in SQL, generating reports/dashboards

Preferred:

• Master's Degree in Business Administration/Management or Information Systems

• 5 or more years of experience in Process Improvement

• Experience working in a SaaS model

• Experience with Health Source (previously known as Burgess)

• Customer service orientation

• Leadership skills

Physical Demands

• Ability to safely and successfully perform the essential job functions consistent with the ADA and other federal, state, and local standards

• Sedentary work that involves sitting or remaining stationary most of the time with occasional need to move around the office to attend meetings, etc.

• Ability to conduct repetitive tasks on a computer, utilizing a mouse, keyboard, and monitor

• Must be able to communicate with customers/team members over the phone/internet meetings

#LI-NA1

Reasonable Accommodation Statement

If you require a reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employment selection process, please direct your inquiries to ...@cai.io or (888) 824 – 8111.

Equal Employment Opportunity Policy Statement

It is the policy of CAI not to discriminate against any employee or applicant due to race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or being a protected veteran. It is also the policy of CAI to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or being a protected veteran, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Employees and applicants of CAI will not be subject to harassment due to race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or being a protected veteran. Additionally, retaliation, including intimidation, threats, or coercion, because an employee or applicant has objected to discrimination, engaged or may engage in filing a complaint, assisted in a review, investigation, or hearing or have otherwise sought to obtain their legal rights under any Federal, State, or local EEO law is prohibited.