Risk Adjustment Quality Assurance Analyst - REMOTE

Position Description

The Senior Quality Assurance Analyst will act as product SME and work collaboratively with development and product teams to ensure a high level of data accuracy related to products delivered to our customers. The Sr. Quality Assurance Analyst will lead and enhance a comprehensive quality assurance program and provide full review and approval of data content related to new development, product enhancements and client production runs.

Location: REMOTE

Responsibilities:

Develop and Maintain a Robust Quality Assurance Program

• Solidify and improve the current quality assurance program supporting the data integrity and accuracy of our client deliverables
• Maintain the policies and procedures that govern the quality review and approval of client facing data
• Work collaboratively with the Risk Adjustment Analytics team to share and capture best practices to support continuous improvement of the Risk Adjustment program

Support Development and Product Teams

• Work closely with the innovations development and product teams to ensure the data quality assurance process is in place and adhered to including: new customer implementation QA, Integrated and Regression testing of updated code deployments, monthly customer production deliverables QA and continuous process improvement
• Develop and maintain test cases, acceptance criteria and automation to ensure adequate testing of data content and quality prior to providing customer access to deliverables and dashboards
• Perform quality assurance tests based on test cases and acceptance criteria
• Document and report out any issues found and work collaboratively with the nnovations development and product team to make necessary corrections

Qualifications and Experience

• 3-5 years of experience analyzing Medicare Advantage (MA), Affordable Care Act (ACA) and/or Medicaid plan data related to:
  • Medical, pharmacy, eligibility, and lab data
  • CMS Risk Adjustment models
  • HEDIS, 5-Star or QRS measure reporting and analysis
• 3+ years of experience providing Integrated and Regression quality assurance acceptance testing for data integrity and accuracy of output data changes related to new code deployment
• 3+ years of advanced MS-SQL Server query writing and analysis
• Strong in test plan and business requirements documentation
• Ability to work within a remote team environment
• Experience with SAS a plus

Academic and Professional Qualifications

• BA or BS degree preferred and/or other relevant combination of training experience and industry experience – healthcare analytics, information systems, hospital administration, quality assurance

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