Expert Quality Assurance Analyst

Welcome to Veradigm, where our Mission is transforming health, insightfully. Join the Veradigm team and help solve many of today’s healthcare challenges being addressed by biopharma, health plans, healthcare providers, health technology partners, and the patients they serve. At Veradigm, our primary focus is on harnessing the power of research, analytics, and artificial intelligence (AI) to develop scalable data-driven solutions that bring significant value to all healthcare stakeholders. Together, we can transform healthcare and enable smarter care for millions of people.

Veradigm Payer

Veradigm Payer Analytics (formerly Pulse8) is an innovative Healthcare Analytics and Technology Company that delivers visibility and transparency for Risk Adjustment, Quality and Pharmacy management programs. We enable health plans and at-risk providers to achieve the greatest financial impact in the Commercial, Health Insurance Exchange, Medicare Advantage, and Medicaid markets.

By combining advanced analytic methodologies with extensive health plan experience, Pulse8 is developing a suite of uniquely pragmatic solutions to change the game in pharmacy benefit management and to compliment the core solutions that are revolutionizing risk adjustment. Pulse8’s flexible business intelligence tools offer near real-time visibility into member, prescriber and pharmacy activity/pricing so our clients can ensure cost-effective, high quality, and clinically appropriate use of the pharmacy benefit.

What's cool about working for Pulse8? We're a close knit team of Healthcare and Technology experts dedicated to helping people live longer, healthier lives. You'll get to help us design and build innovative solutions from the ground up and can do lots of interesting things in an entrepreneurial culture. We offer competitive benefits and much, much more!

Job Summary

The Expert Quality Assurance Analyst will act as SME and work collaboratively with Pulse8 development and product teams to ensure a high level of data accuracy related to the products delivered to our customers. The Expert 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.

What you will contribute:

1. 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 Pulse8 Quality Assurance team to share and capture best practices to support continuous improvement of the Quality Innovations program
• Develop and maintain processes, including test cases and acceptance criteria, for Quality Innovations program requirements

2. Support Development and Product Teams

• Work closely with the quality, development and product teams to ensure the quality assurance process is in place and adhered to including: SME to SME reviews, QA automation and enhancements.
• 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 implementations, continuous product enhancements, and customer monthly production data runs.
• Develop and maintain test cases, acceptance criteria and automation to ensure adequate testing of data content and quality prior to delivery to customer or providing customer access to the application/dashboards
• Perform quality assurance tests based on the test cases and acceptance criteria.
• Document and report out findings and work collaboratively with the Quality Innovations development and product team to correct any findings. Preferably this report out would be in visible dashboard for the team.

The ideal candidate will have:

• BA or BS degree preferred and/or other relevant combination of training and experience and industry experience – healthcare analytics, information systems and/or software engineering 
• 3-5 years of experience analyzing medical and pharmacy claims for the healthcare industry
• 3-5 years expert level experience in providing business process support for assigned products 
• 5+ years of experience completing quality assurance testing for a healthcare software development company – specifically automation and the writing and executing of test cases and acceptance criteria 
• 3+ years of experience with data visualization or business intelligence tools.
• 3 – 5 years working knowledge of SQL
• Agile experience
• Ability to work within a remote team environment
• Proficiency with data manipulation and interpretation

Preferred Skills & Experience:

• Knowledge of healthcare with relative experience in: Claims data, Risk Adjustment, Medicare Advantage, ACA, Quality (5-Star, QRS, HEDIS) and Medicaid
• Experience with Business Intelligence tools
• Experience using SAS

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Travel Requirements: Less than 10% 

Compliance    Job responsibilities include fostering the Company’s compliance with all applicable laws and regulations, adherence to the Code of Conduct and Compliance Program requirements, policies and procedures. Compliance is everyone’s responsibility.

Enhancing Lives and Building Careers

Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work and to further their professional development. Together, we are In the Network. Interested in learning more?

Take a look at our Culture, Benefits, Early Talent Program, and Additional Openings.

We strongly advocate that our associates receive all CDC recommended vaccinations in prevention of COVID-19.

Visa Sponsorship is not offered for this position.

At Veradigm, our greatest strength comes from bringing together talented people with diverse perspectives to support the needs of healthcare providers, life science companies, health plans, and the patients they serve. The Veradigm Network is a dynamic, open community of solutions, external partners, and cutting-edge artificial intelligence technologies that provide advanced insights, technology, and data-driven solutions. Veradigm offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.

Veradigm’s policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Veradigm must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire. Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.

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