Medicaid Pharmacy Benefits Administrator Business Quality Assurance Analyst

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