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Navitus Health Solutions · 1 week ago

Systems and Quality Analyst Manager

United States

Full-time

Remote

Mid, Senior Level

$113K/yr - $141K/yr

4+ years exp

Navitus Health Solutions is committed to making medications more affordable through innovative pharmacy benefit management. The Systems and Quality Analyst Manager will oversee the development, implementation, and maintenance of Medicaid products while ensuring compliance with industry standards and regulations.

Health CareInformation Technology

H1B Sponsor Likely

Responsibilities

Develop and maintain deep knowledge of NCPDP pharmacy POS claims processing, Federal and Supplemental Rebates and Analytics Standards

Develop an understanding of unique attributes within a claim transaction where contracted State governments apply specific regulatory requirements to support their programs

Strong understanding of software development lifecycle (SDLC), testing methodologies (e.g., Agile, Waterfall), and QA tools (e.g., test management, automation frameworks). Understand the competitive landscape, regulatory lifecycle and related government processes surrounding FFS

Develop and implement comprehensive QA strategies, plans, and procedures. Understands industry standards, best practices, and emerging trends in quality assurance

Define quality standards and ensure adherence throughout the product development lifecycle

Oversee the execution of testing activities, including functional, system, regression, and performance testing

Collaborate with product managers, developers, and other stakeholders to integrate quality into the product development process

Communicate quality-related information to various teams and management

Monitor key quality metrics and identify areas for improvement. Analyze test results and defect data to identify trends and root causes. Conduct audits and inspections to ensure compliance with quality standards

Work with the project management office to utilize and enhance tools that support the requirements, development, and testing processes

Implement and maintain test automation strategies to improve efficiency and coverage

Collaborate with the training/development staff to deliver and update training documentation

Create and update status reports upon request that communicate the health of the products

Perform quality analysis on all aspects of claims, rebates, portal etc. and document findings and work with IT to remediate any issues

Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives

Other duties as assigned

Qualification

Claims Processing systemsQA Manager experienceMedicaid Business requirementsSoftware Development LifecycleAgile developmentMicrosoft WordMicrosoft ExcelMicrosoft VisioMicrosoft PowerPointMicrosoft ProjectTeam Foundation ServerBusiness Analysis CertificationHealthcare industry practicesHIPAA knowledgePharmacy benefits knowledgeUI mockupsWireframingTesting methodologies

Required

Bachelor's degree or equivalent work experience required

4 years of Claims Processing systems and QA Manager experience for a healthcare company required

Elicitation and documentation of Medicaid Business requirements required

QA of the implementation of government regulations into software development activities required

Participating in an agile development project team required

Experience with core software applications, including Microsoft Word and Excel required

Knowledge of Software Development Lifecycle (SDLC) methodologies of client organizations required

Preferred

Relevant certifications from recognized industry organizations preferred

Business Analysis Certification (PMI, IIBA) or College level program preferred

Experience in roles like a Business Analyst, Business Systems Analyst, or Product Manager preferred

Experience with Microsoft Visio, PowerPoint, Project and Team Foundation Server (TFS) preferred

3 years' experience in large scale system implementation projects preferred

Healthcare industry business practices and HIPAA knowledge preferred

Experience with pharmacy benefits and claims processing preferred

Experience in mockups, wireframing and prototyping UI with UX principles preferred

Experience with multiple testing methodologies, including automation preferred

Benefits

Top of the industry benefits for Health, Dental, and Vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K company match of up to 5% - No vesting requirement

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and Professional Membership assistance

Referral Bonus Program – up to $750!

Company

Navitus Health Solutions

Navitus Health Solutions LLC is a full service, URAC-accredited pharmacy benefit management company.

Founded in 2003

Appleton, Wisconsin, USA

1001-5000 employees

https://www.navitus.com/

H1B Sponsorship

Navitus Health Solutions has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

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Trends of Total Sponsorships

2022 (1)