Quality Analyst II

### Exemption Status:

United States of America (Non-Exempt)### $29.32 - $38.85 - $48.38“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”This

position is not eligible for Sponsorship.

Med Impact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

At Med Impact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry.

We are the premier Pharmacy Benefits Management solution!#
** Job Description
**** Summary
* * Participates in the execution of an effective quality assurance program to ensure that the operational component of Med Impact’s PBM programs and services meet client requirements and government regulations.  Works under general supervision with a limited degree of independence.
** Essential Duties and Responsibilities
** include the following. Other duties may be assigned.
* Develop and execute department's quality assurance procedures and participate in quality improvement initiatives. Ensure that deliverables are on time and meet the quality levels expected by Medlmpact's internal and external customers and the Centers for Medicare and Medicaid Services (CMS).
* Understanding of PBM regulations and related CMS guidance. Responsible for proactive review of all CMS regulation and guidance. Provides assessment of requirements when CMS revises guidelines and implements quality and compliance monitoring changes to ensure compliance to new guidelines.
* Understanding of quality methodologies, practices and techniques.
* Execute and track quality and compliance review projects. Develop quality review procedures, perform tests and document test results. Participate in evaluations and audits of PBM services provided by Medlmpact. Implement corrective action plans in response to negative findings
* Test multiple files with high volumes of data
* Interface with internal operational areas and with external customers to improve the quality of customers' implementation of the PBM program. Areas include Part D Benefit Setup, Part D Pharmacy Network Setup, CMS Plan Finder Submissions, Member Part D Explanation of Benefit Statements, CMS Reporting, Prescription Drug Event Reporting, Part D Policy and Procedures, and other PBM services provided by Medlmpact
* Respond to inquiries from internal and external customers regarding quality review and compliance policy and procedures. Implement corrective action plans in response to negative findings.
* Keep management team updated on significant issues or developments identified during quality control activities and actions being taken to improve the situation.
** Supervisory Responsibilities
** No supervisory responsibilities                                   
** Client Responsibilities
** This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).  One must be able to; manage difficult or emotional client situations;
Respond promptly to client needs;
Solicit client feedback to improve service;
Respond to requests for service and assistance from clients;
Meet commitments to clients.
** Qualifications
* * To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
** Education and/or Experience
*…