Clinical Operations Analyst - PBM : work from home

Job Description

Job Title: ‘Clinical Operations Analyst’ Estimated Length of Assignment: 06+ Months with Possible Extension (The dates provided are only an estimate and not a guarantee) Negotiable Estd. Pay Range - $24.00/Hour to $26.32/Hour on W2 (USD) – All Inclusive Work Type: Work from Home – Fully Remote Schedule – MON - FRI 8:30am - 5:00pm CT (can be located anywhere in US, but will need to work CT hours) Remote - Shift: MON - FRI 8:30am - 5:00pm CT (can be located anywhere in US, but will need to work CT hours) Questionnaire

• Please add city and state at the top of the resume.
• Do they have reliable internet at home?
• Do they have a quiet, secure place to work at home remotely?
• Do they have PBM experience? If so, how many years?

Interview Process: 1 IV, Teams (on-camera), 60 mins; Possible 2nd Round IV if needed The Analyst will develop test plans, test cases and test scripts for projects, among other assigned duties. The Analyst will perform testing on various software and reporting systems. The Analyst will work closely with PA Admin and Medicare Operations to test and validate the utilization management (UM) criteria, decision trees, drug lists, and letters that are loaded and functioning properly in the PA (MHK) system. Also, the analyst will be responsible for configuration quality control, code testing and test case writing. Additional responsibilities: include ensuring the quality of PA Admin products for internal/external business users by testing cases and doing regression testing. As a Analyst developing and executing formal test plans to ensure the delivery of quality software and to ensure that all information systems products and services meet minimum organization standards and end-user requirements. Primary Job Duties & Responsibilities:

• Assists in executing the planning, implementation, and execution of Clinical Service operations to ensure compliance with regulatory requirements in support of the organization's objectives.
• Analyzes error reports and resolves error trends, identifies Clinical Services operational risks, and provides solutions to senior managers and senior individual contributors.
• Analyzes detailed, accurate reports for senior leadership, vendors, and senior clinical strategists to ensure data quality and integrity.
• Reviews clinical services training needs with resources, budgets, and analysis, ensuring continuous improvement while meeting goals and objectives.
• Facilitates the clinical services review process with supervisory staff, providing detailed reports to ensure consistent information.
• Develops basic strategies for delivery on stakeholder and business performance to senior managers, ensuring consistent communication and analysis.
• Oversees daily workload and clinical services resource management, collecting financial analysis, budget gaps, and pricing consistency to ensure consistent performance at the company's standards.
• Manages resources to develop the methodology for analyzing and reporting clinical services team performance data to senior managers and stakeholders.
• Administers strategic review processes ensuring continuous improvement, compliance, and high performance clinical support protocols and standards are upheld.

Prior Relevant Work Experience

• 0-2 years

Essential Qualifications:

• Basic awareness of problem solving and decision-making skills

Required:

• 1 plus years of quality assurances or software testing and
• 5 plus years Software knowledge (MS Office Suite including Access and Project)
• Written and Verbal Communication Skills

Preferred:

• PBM Knowledge
• Analytical Skills
• Ability to work in teams or independent
• Time Management skills
• Medicare Knowledge
• Able to thrive in time sensitive situations

The Analyst will develop test plans, test cases and test scripts for projects, among other assigned duties. The Analyst will perform testing on various software and reporting systems. The Analyst will work closely with PA Admin and Medicare Operations to test and validate the utilization management (UM) criteria, decision trees, drug lists, and letters that are loaded and functioning properly in the PA (MHK) system. Also, the analyst will be responsible for configuration quality control, code testing and test case writing. Additional responsibilities: include ensuring the quality of PA Admin products for internal/external business users by testing