Quality Analyst

 Responsibilities:

• Understanding client needs and Clinical requirements, translate into Test Scenarios to validate Clinical Configuration and Benefits Coding.
• Building relationships with key client partners through a consultative approach to fully understand clinical components of client benefit plan design needs.
• Translating Client needs and requirements to internal CVS Health team such as Coding and Quality Analysis team.
• Providing timely communications to provide status updates and make decisions relative to client clinical set up.
• Expertise on EZTEST (claim processing tool), Sales force, EZQYERY, EXCEL Macro, Formulary management system and Benefit Serve/Benefit builder.
• Translate CMS and state mandate clinical program/rule and define business rule and validate before code promotion to production.
• Define Clinical test requirements, create test plans, and execute test scenarios, capture test results, present test results to all stakeholders.
• Develop process improvement initiatives in support of department efficiency. Pinpoint areas of opportunity and training needs.
• Work through the various phases of the project until all issues have been resolved, cleanup complete and all reportable items are closed to the satisfaction.

Key Skills:

• Detail-oriented. 
• Time management. 
• Flexibility in analytical approaches. 
• Collaboration and teamwork. 
• Critical thinking. 
• Communication.

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