Medicaid Pharmacy Benefits Administrator Business Quality Apply
Direct Client
Phone/Skype Hire. Onsite from day 1 / Hybrid
Location: Raleigh, NC
Duration: 12+ months
Responsibilities
The PBA Business Quality Assurance Analyst will serve as a member of the Medicaid Enterprise System(MES) Program within the PBA Business space. This position is responsible for the following activities to implement the PBA application for DHB Pharmacy Business.
- Experience assessing the testability of the requirements and providing business guidance in developing the test case scenarios and quality assurance based on the business requirements.
- Experience in validating the test results and evaluating the quality assurance to concur they meet the business vision.
- Experience in performing quality assurance across different stages of the application testing such as Integration testing, User Acceptance Testing, Regression Testing and State End to End Testing.
- Collaborates and communicates with workgroups around product deliverables with PBA project team, Product Owners and Business Leads.
- Experiencing in performing the quality assurance on the regression testing cases and provide the business guidance and expectations to achieve the business vision.
- Experience with the test and defect management tools, MF ALM and JIRA preferred.
- Work with end users to ensure user acceptancetesting is through and complete.
- Experience with Agile Methodology and Scrum.
- Experience in validating automation testing scenarios and define business expectations.
- Collaborate with the production manager and product owner to analyze requirements and identify use cases and test case scenarios required to be executed for the module.
- In-depth knowledge and understanding of all functions and business segments in healthcare that meet departmental goals.
- Provides feedback and input to senior level decision-makers to develop long-range strategic alternatives for product solutions.
- Must have experience with Medicaid/Health Care and/or Managed Care areas.
- Good understanding of CMS MITA Framework across Medicaid Business Architecture, Information Architecture and Technical Architecture initiatives and activities.
- Prior experience with Medicaid applications and preferably across Pharmacy Functional Areas.
- Provide in-person, conference calls, or virtual training on product knowledge, usage, and implementation.
- Ensures compliance with all applicable policies and procedures.
- Supporting the product lifecycle from conception through implementation.
- Adhere to the Product Management guidelines.
- Familiarity with CMS Certification process
Skills Needed
Expert knowledge of the Medicaid Pharmacy (PBA) processes, roles, and intended outcomes Required 3 Years
Knowledge of the Enterprise IT Systems integration principle and associated change management best practices Required 5 Years
Demonstrate ability to manage multiple priorities and projects, and function in a fast passed moving constantly changing, deadline-driven environment Required 5 Years
Proficient in Microsoft Project, Word, Excel, PowerPoint, Access, and Adobe software Required 5 Years
Experience in creating test cases and defining the business test scenarios and use cases Required 5 Years
Experience with Defect Management and Testing tools, JIRA MF ALM are preferred. Required 5 Years
Excellent communication skills and attention to detail with specific experience developing, editing, and presenting summaries, reports, and complex in Required 5 Years
Proven experience and working knowledge of the agile development methodologies, environment, and tools Highly desired 5 Years
Experience using or implementing Cloud technologies Iaas, Paas, Saas Highly desired 5 Years
Experience handling HIPPA and PII data Required 5 Years
Ability to gather data via diverse means (i.e., interviews, observation, surveys, existing written documentation) and interpret relevant information Highly desired 5 Years
Managed care knowledge or experience Required 3 Years
MITA knowledge and understanding of the CMS's Seven Standards and conditions Required 5 Years
Medicaid program knowledge or related Healthcare Information experience Required 5 Years