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Quality Control Analyst III at Change Healthcare

Quality Control Analyst III

Change Healthcare Atlanta, GA Full-Time

Change Healthcare is a leading healthcare technology company with a mission to inspire a better healthcare system. We deliver innovative solutions to patients, hospitals, and insurance companies to improve clinical decision making, simplify financial processes, and enable better patient experiences to improve lives and support healthier communities.

The primary responsibility of the Quality Control Analyst III is to provide technical and administrative support for the maintenance and operation of pharmacy claims processing systems. This includes providing support such as trouble-shooting, performing quality control and quality assurance, and testing of production systems. Responsible for processing system change requests, as well as gathering and documenting new system requirements. Proactively work with managers, team leaders, data analysts, and members of the project management team to assign work and set deadlines . C oordinate, track, and report on the completion of work assignments.

Primary Duties/Responsibility 1: Serve as an informational resource for the client/team by providing support pertaining to claims processing.

Testing support

  • Perform senior review on test plans and test cases.

  • Support the Change Control Board Process by adhering to the required documentation and supporting the process by assuring the enhancement is correct in the production system.

  • Final review use cases, test plans, test scenarios and test cases based on the defined requirements to support the audit.

  • Conduct user acceptance testing for system and configuration changes

30%

Primary Duties/Responsibility 2: Manage and grow the Quality Control Analyst team

Change Request Support

  • Process system Change Requests by documenting scope, functionality, and level of effort in a Service Request form.

  • Track progress on Change Requests and completion of work.

  • Adhere to all change control requirements.

  • Act as a liaison between the Account Manager and the audit process

30%

Primary Duties/Responsibility 3: Serve as a system support for the Configuration Team system.

  • Support data and configuration maintenance of the POS, Formulary and Preferred Drug List applications by analyzing impact of data changes to the processing of real time pharmacy claims.

  • Report changes to account managers in actionable format.

15%

Primary Duties/Responsibility 4: Serve as an expert user of the pharmacy claims processing system.

Point of Sale System Support

  • Serve as an expert user of the pharmacy claim processing systems

  • Support the Account Management team by trouble shooting pharmacy claims processing issues

  • Serve as an informational resource for the client by providing second tier support pertaining to system inquiries, and data files/extracts

  • Act as a Subject Matter Expert (SME) of the pharmacy systems with a new contract or when an account manager needs to make a significant change to the system.

Requirements Gathering

  • Assist in documenting business and functional requirements as a subject matter expert of the pharmacy systems

  • Track progress on Change Requests and completion of work

  • Adhere to all change control requirements

  • Collaborate with BA on user stories or acceptance criteria with CR

  • Track and update progress in the change control process and JIRA tracking system

  • Communicate business and functional requirements to developers, operations team and business users

15%

Primary Duties/Responsibility 5: Support Leadership with new contract opportunities

Communication

  • Establish and maintain effective lines of communication and cooperation with Managers, team leaders, Reporting Analysts, Account Managers, members of the Project Management Team, and the client

  • Obtain sign off from Account management team on QA testing

QUALIFICATIONS/COMPETENCIES/SKILLS:

  • Ability to manage multiple tasks and meet stated deadlines for those tasks

  • Keen attention to detail

  • Strong interpersonal, verbal, and written communication skills

  • Adept at listening, confirming purpose, and tracking and managing output in a timely and accurate manner

  • Ability to work effectively with others in a time-constrained environment

  • Capacity to learn proprietary systems, tools and processes to efficiently and accurately implement contracted solutions

  • Strong analytical and time management skills

  • Ability to manage multiple projects concurrently

  • Work well as a member of a team with positive energy

  • Ability to work with minimal supervision

  • Drive and desire to follow through on all aspects of a project

  • Understanding of how to interpret customer business needs and translate them into system and operational requirements

    EDUCATIONAL REQUIREMENTS

Bachelors degree in Healthcare or Software Development or a related field. Work experience may substitute for education requirement.

RELATED EXPERIENCE REQUIREMENTS/QUALIFICATIONS

  • 4 years experience in Software Development industry

  • 4 years experience in Healthcare industry

  • Experience with requirement gathering and professional documentation

PREFERRED QUALIFICATION

  • Experience with client support

WORKING CONDITIONS:

  • General office demands

    Diversity, Equity & Inclusion :

    At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs. Learn more at [ Link removed ] - Click here to apply to Quality Control Analyst III Feeling Inspired? Ready to #MakeAChange? Apply today!

    COVID Vaccination Requirements

We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and, when j ob-related and consistent with business necessity , we may require periodic testing for certain roles. Some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.

Equal Opportunity/Affirmative Action Statement

Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at [ Link removed ] - Click here to apply to Quality Control Analyst III and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.

If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to [ Email address blocked ] - Click here to apply to Quality Control Analyst III with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.

Click here https://www.dol.gov/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy.

California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcares Privacy Notice to California Job Applicants Regarding the Collection of Personal Information ([ Link removed ] - Click here to apply to Quality Control Analyst III .

Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.

Change Healthcare is an equal opportunity employer. All qualified applicant will reveive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status.

Recommended Skills

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