Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title

QA Analyst - RemoteJob Description

The Quality Assurance (QA) Analyst performs complex quality reviews and serves as a subject matter expert and primary information resource for any escalated QA issues and questions. This role provides project support and feedback on implementations and reporting for QA-related activities.

Responsibilities

• Perform research and assist leadership in identification of potential missed turnaround times on review related to applicable quality tests
• Perform ongoing inter-rater reliability exercises and quality reviews for less tenured staff and provide performance feedback and information to identify areas of improvement
• Perform complex quality reviews and analysis of cases to prevent errors based on strict compliance, service level agreements, and regulatory guidance
• Discover outliers and areas of improvement on work product of reviewers; provide feedback for improvement to prevent quality issues
• Assist in the gathering, documenting, and implementations of requirements for new and future system enhancements
• Serve as liaison for directing unresolved issues for further evaluation and resolution
• Collaborate with trainers and writers to provide feedback for training modules and documentation
• Other duties as assigned

Education & Experience

• Bachelor's degree in Business, Liberal Arts, or related area of study, or equivalent combination of education and/or related work experience; HS diploma or GED is required

• 2 years of experience within Claims Processing, Audit, Quality or Pharmacy
• Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

• Strong organizational, analytical, interpretive, and time management skills
• Ability to make consistent and unbiased decisions
• Strong interpersonal, verbal and written communication skills
• Ability to provide work direction to others
• Ability to work under strict timelines while managing multiple priorities simultaneously
• Ability to analyze data using analytical tools (e.g. Microsoft Excel)

Preferred Qualifications

• National Pharmacy Technician Certification through PTCB or ExCPT (CPhT) or Licensed Practical Nurse certification if working in Medicare
• Healthcare, audit, and/or reporting and metrics environment experience
• Experience using RxClaim
• Experience in benefit design and review process for multiple clients
• PBM or healthcare experience

Physical Demands

• Ability to work in a flexible schedule which may include weekends, holidays, or shifts outside of Prime's core business hours of 9:00am-3:00pm
• Constantly required to sit, use hands to handle or feel, talk and hear
• Frequently required to reach with hands and arms
• Occasionally required to stand, walk and stoop, kneel, and crouch
• Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

Potential pay for this position ranges from $59,000.00 - $94,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.