Pharmacy Benefit and Quality Assurance Analyst
SaaS / Software · Remote / National

Our client in the pharmaceutical industry is looking for a Pharmacy Benefit and Quality Assurance Analyst to add to their team. You will be responsible for the oversight of design, development, testing, deployment, and documentation of plan/benefit design for each pharmacy benefit management (PBM) contract. You will also collaborate with different departments in the organization and act as a liaison between assigned clients, vendors, and the various departments. This is a great opportunity to join a firm with a great company culture and do work that makes a difference. Pharmacy Benefit and Quality Assurance Analyst Responsibilities • Maintain detailed documentation of plan/benefit set-up and on-going requirements • Create and maintain plan/benefit design rules and limitations • Develop standard operating procedures for plan build documentation • Establish ongoing Quality Assurance processes • Develop, maintain, and format client data and reporting • Analyze reports to resolve discrepancies and errors • Analyze claims data and coordinate with business reporting teams • Evaluate processed claims • Implement and maintain maximum allowable cost list