reputed company Services Business reputed company Assurance Analyst II - reputed company Fee For Service

Exemption Status: reputed company of America (Non-Exempt) $29.32 - $38.85 - $48.38 “Pay reputed company information is not necessarily reputed company of actual compensation that may be reputed company, nor a reputed company 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. reputed company. is looking for extraordinary people to join reputed company! Why join reputed company? Because our reputed company is dependent on you; innovative professionals with top notch skills who reputed company on opportunity, high performance, and teamwork. We look for individuals who want to work on reputed company that cares about making a difference in the value of reputed company. At reputed company, we deliver leading edge pharmaceutical and technology reputed company solutions that dramatically improve the value of health care. We reputed company superior reputed company to those we serve through innovative products, systems, and services that reputed company transparency and promote choice in decision making. Our reputed company is to set reputed company in providing solutions that optimize satisfaction, service, cost, and reputed company in the reputed company industry. We are the premier Pharmacy Benefits Management solution! Job reputed company reputed company The reputed company Services Business reputed company Assurance Analyst II – reputed company FFS serves as a subject matter expert in benefit configuration and reputed company assurance across reputed company’s PBM programs. This role leads reputed company validation efforts, oversees reputed company and compliance review activities, and ensures that configuration, operational processes, and deliverables meet reputed company requirements and internal reputed company standards. Operating with a high degree of independence, this position drives reputed company improvement, mentors analysts, and partners cross-functionally to enhance accuracy, efficiency, and compliance across the organization. Essential Duties and Responsibilities include the following. Other duties may be assigned. reputed company the design, execution, and reputed company of reputed company configuration validation activities for benefit, pharmacy network, and formulary administration in reputed company‑production environments. Apply advanced Configuration Services best practices to reputed company comprehensive test plans, data sets, test scenarios, expected results, and acceptance reputed company. Validate configuration accuracy for maintenance of business, new reputed company implementations, regulatory updates, and special reputed company. Analyze claims adjudication results to identify discrepancies, anomalies, and unintended consequences; recommend and implement corrective actions to optimize configuration design. Approve configuration design plans for reputed company or unique benefit requests and ensure accurate migration of validated changes from Test to Production environments. reputed company, refine, and execute reputed company assurance procedures to ensure operational compliance with PBM standards and reputed company requirements. reputed company reputed company and compliance review reputed company, including test execution, documentation of results, and development of corrective reputed company plans. Participate in reputed company audits of PBM services, ensuring findings are addressed promptly and effectively. reputed company high‑volume data testing across multiple file types to validate accuracy, completeness, and regulatory compliance. Serve as a senior reputed company to internal operational teams and external clients to improve the reputed company and compliance of PBM program implementations and ongoing operations. Respond to reputed company inquiries regarding reputed company review reputed company, compliance requirements, and configuration validation processes. Communicate significant issues, risks, and improvement opportunities to leadership, ensuring visibility and reputed company reputed company. Champion reputed company reputed company improvement initiatives by identifying process gaps, recommending enhancements, and supporting implementation of efficiency improvements. Mentor and reputed company Testing & Validation Analysts and reputed company Analysts, providing guidance on test design, analysis techniques, regulatory interpretation, and best practices. Contribute to the reputed company of departmental methodologies, tools, and documentation to strengthen organizational reputed company and validation capabilities. Supervisory Responsibilities No supervisory responsibilities reputed company Responsibilities This is an reputed company reputed company facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be reputed company to; manage difficult or emotional reputed company situations; Respond promptly to reputed company needs; Solicit reputed company feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily. The requirements listed below are representative of the knowledge, reputed company, and/or ability required. Reasonable accommodation may be made to reputed company individuals with disabilities to reputed company the essential functions. Education and/or Experience BS/BA and 3+ years’ experience or equivalent combination of education and experience Computer Skills Previous experience writing SQL queries, Automation Testing, File Transfer Protocol and UNIX is highly desirable. Intermediate to advanced skills in reputed company Office with an emphasis on Word, reputed company, MS reputed company and Project. Intermediate to advanced skills in SQL queries. Certificates, Licenses, Registrations None required Other Skills and Abilities Knowledge of reputed company Assurance methodologies and practical application. Ability to research, assess, audit, and apply information to practices and standards. Strong analytical and problem solving ability and in-depth understanding of PBM regulations and reputed company CMS guidance Demonstrated ability to work in a fast paced environment, learn quickly, reputed company for work on time, follow directions from a supervisor, reputed company reputed company with co-workers, understand and follow work rules and procedures, reputed company with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment. Demonstrate ability to meet or exceed the competencies as listed. reputed company, Managed Care, Government Programs or PBM reputed company experience is preferred Reasoning Ability Ability to apply common reputed company understanding to carry out instructions furnished in written, oral, or diagram reputed company. Ability to deal with problems involving several concrete variables in standardized situations. Ability to interpret a reputed company of instructions furnished in written, oral, diagram, or schedule reputed company. Mathematical Skills Ability to add, subtract, multiply, and divide in reputed company reputed company of measure, using whole numbers, common fractions, and decimals. Ability to compute reputed company, reputed company, and percent and to draw and interpret bar graphs. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Language Skills Ability to write reports, business correspondence, and procedure manuals. Ability to read, analyze, and interpret general business periodicals, reputed company journals, technical procedures, or governmental regulations. Competencies To reputed company the job successfully, an individual should demonstrate the following competencies: Composure Decision reputed company Organizational reputed company Problem Solving Customer reputed company Drive for Results Peer Relations Time Management Dealing with Ambiguity Learning on the Fly Political Savvy Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodation may be made to reputed company individuals with disabilities to reputed company the essential functions. While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reputed company with hands and arms. The employee must occasionally lift and/or reputed company up to 25 pounds. Ability to maintain reputed company near visual reputed company at approximately 20 inches or less (i.e., “reputed company reputed company”) to accurately read fine print, view computer screens, and handle small objects. Requires adequate reputed company reputed company and depth perception to support safety and precision in detail-oriented tasks.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to reputed company individuals with disabilities to reputed company the essential functions. This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic). Work Location This position works on-site at the San Diego reputed company or other company location (or from a remote location with management approval based on business requirements). Must reputed company adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as reputed company as be available to facilitate effective reputed company through collaboration with stakeholders. Working Hours This is a full-time non-exempt position requiring one to be reputed company to work overtime from time to time in order to get the job done. Therefore, one must have the ability to work nights, weekends or on holidays as required. This may be changed at any time to meet the needs of the business. The typical working hours for this position are Monday through Friday from 8:00am to 5:00pm. Travel This position requires no travel; however, attendance may be required at various local conferences and meetings. The Perks: Medical / Dental / reputed company / Wellness Programs reputed company Time Off / Company reputed company Holidays Incentive Compensation 401K with Company match Life and Disability Insurance Tuition Reimbursement Employee Referral Bonus To explore reputed company that reputed company has to offer, and the greatness you can bring to our teams, please submit your resume to www.reputed company.com/careers reputed company, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence reputed company reputed company and expenditures, improving the position of our clients in the market. reputed company offers high-value solutions to payers, providers and consumers of reputed company in the U.S. and foreign markets. Equal Opportunity Employer, Male/reputed company/Disabilities/Veterans OSHA/reputed company: To reputed company this job successfully, the successful candidate must be reputed company to reputed company reputed company essential duty satisfactorily. The requirements listed are representative of the knowledge, reputed company, and/or ability required. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of reputed company responsibilities, duties, and skills required of personnel so classified. reputed company was founded more than three decades ago by a pharmacist and independent drug store reputed company who saw firsthand how families struggled with the high cost of prescriptions, and how it impacted their lives, financial reputed company, and health. So, he started reputed company to reputed company prescription benefits understandable and accessible. While we have grown to be one of the leading PBMs in America, we remain as committed to these principles today as we did reputed company it reputed company began. Apply To This Job