- Optimize testing and monitoring activities to ensure the quality of the systems and processes supporting the company's operation.
- Develop into a subject matter expert (SME) on certain lines of business and adjudication logic while stay current with regulatory guidelines.
- Develop, document, and execute test plans, and test cases and scripts based on business functional requirements (independent of Software Test Engineer test plan).
- Analyze, document, and report on test results to business stakeholders and SDLC teams.
- Document and track issues identified during testing activities to ensure defect resolution and testing completion.
- Perform functional testing of the specific adjudication changes being requested, their integration with the specific client rule being tested and related impact to other products. (e.g. member portal, platform visualization).
- Review executed test results with Scrum team, business users, and requestors to ensure acceptance and approval of the results.
- Log all documentation of test plan execution and results in a centralized area available for all SDLC teams.
- Contribute to the business requirement gathering process by identifying missing requirements based on test-cases development and testing experience.
- Collaborate in the development of new ideas and requirements to resolve testing and system's issues, and improve current systems based on testing results. Collaborate with the Software Test Engineering team to develop and improve testing strategies, techniques, procedures, and tools
- Participate in product grooming and refinement meetings to gather understanding of new system functionalities and requirements that will require testing and monitoring.
- Team up to support users during issue-solving activities, and day-to-day system operation.
- Bachelor's degree in Business, Engineering, Healthcare, or related field. (In lieu of a degree, equivalent relevant work experience may be considered.)
- 3+ years of experience in a healthcare, health plan and/or pharmacy benefit manager (PBM) setting.
- Experience as a detail-oriented problem-solver, able to quickly spot trends and discrepancies.
- Ability to analyze large data sets while able to use dashboard tools (e.g. Tableau, QVW and Excel tools).
- Ability to leverage strong analytical and critical thinking by being, innovative, accountable and a team worker with a desire to be challenged.
- Experience with Microsoft Office products (e.g. Excel, Power BI).
- Excellent oral and written communication skills.
- Fluency in Spanish is a plus.
- Experience in testing methodologies is a plus.
- Experience with software development life cycle (SDLC) and quality assurance (QA) is a plus.
- Experience with SQL Management Studios is a plus.
- Knowledge of quality assurance practices and tools is a plus.
- Knowledge of operational standards and processes for healthcare, pharmacy, pharmacy benefit management, Medicare Part D, and Centers for Medicare and Medicaid Services (CMS) regulations is a plus.
- Action for Bias
- Solution Seeker
- Team Player
- Must be able to access and navigate each department at the organization's facilities.
- Sedentary work that primarily involves sitting/standing.
-
atom 34
hace 6 días
Fresenius Medical Care, North America Caguas, Puerto Rico Permanent position, De jornada completaPURPOSE AND SCOPE: · Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. For a defined Area, responsible for supervising the overall operation, cond ...
-
Upbound Group San Juan, Puerto Rico De jornada completaJob Description · Rent A Center · ¿Listo para hacer su mejor trabajo? · ¿Está interesado en un ingreso mínimo $ por hora? · ¿Por qué debería aplicar en sólo un par de clicks? · Tiempo Personal Libre y Domingos Libres -- Estamos cerrados · Empleo a tiempo completo y horari ...
-
Quality Technician
hace 6 días
Terumo Medical Corporation Caguas, Puerto RicoJob Summary · Provides technical support to Quality System operations contributing to the development of any process/tools changes to improve overall quality related to the role · Job Details/Responsibilities · Ensure compliance with all TPR procedures and all applicable regul ...
-
Quality Technician
hace 3 días
TPR - Quality Caguas, Puerto RicoTerumo Medical Corporation (TMC) develops, manufactures, and markets a complete, solutions-based portfolio of high-quality medical devices used in a broad range of applications for numerous areas of the healthcare industry. TMC places a premium on providing customers with world-c ...
-
Sr. Biologist-Microbiologist
hace 1 semana
Lilly San Juan, Puerto Rico De jornada completaWe're looking for people who are determined to make life better for people around the world. · Position Summary: · Provide technical support to daily operations in Microbiology Lab with safety, quality and operational excellence mindset. Maintains quality systems and procedures ...
-
risk analyst
hace 6 días
First BanCorp San Juan, Puerto RicoRISK ANALYST – · CORPORATE CREDIT RISK MANAGEMENT – · FIRSTBANK PR · Our Company · At FirstBank PR , we strive to be a trusted advisor to our clients and our employees are the ones that ensure we deliver on our promise of excellence in personalized customer service. Our more ...
-
Sr Mgr Clinical Education
hace 3 días
Fresenius Medical Care, North America San Juan, Puerto Rico Permanent position, De jornada completaPURPOSE AND SCOPE: · Directs the planning, implementation, and execution of clinical, quality, and customer service training programs to promote quality patient care and achievement of corporate goals, with adherence to policies and procedures using generational learning theorie ...
-
Senior Software Engineer
hace 3 días
El Comeback San Juan, Puerto Rico***El Comeback is a non-profit program from ConPRmetidos that attracts and retains professional talent for Puerto Rico-based jobs. Register at to get matched with professional opportunities on the island. Candidates' searches for positions posted by El Comeback are done on behal ...
-
Associate, Sales
hace 2 días
Oriental San Juan, Puerto Rico De jornada completaDescription · Summary · The Associate, Sales & Services (Branches), provides an excellent customer service experience while identifying client financial needs in order to present alternatives. Finds integrated and alternative solutions while cross-selling bank products such as l ...
-
Associate, Sales
hace 6 días
Oriental San Juan, Puerto Rico De jornada completaThe Associate, Sales & Services (Branches), provides an excellent customer service experience while identifying client financial needs in order to present alternatives. Finds integrated and alternative solutions while cross-selling bank products such as loans, accounts, investmen ...
-
Manufacturing Technician I
hace 1 semana
Thermo Fisher Scientific San Juan, Puerto Rico De jornada completaShift: Monday to Friday 5:30 am to 2 pm · As part of the Thermo Fisher Scientific team, you'll discover meaningful work that makes a positive impact on a global scale. Join our colleagues in bringing our Mission to life every day to enable our customers to make the world healthi ...
-
Associate, Sales
hace 3 días
Oriental San Juan, Puerto Rico De jornada completaThe Associate, Sales & Services (Branches), provides an excellent customer service experience while identifying client financial needs in order to present alternatives. Finds integrated and alternative solutions while cross-selling bank products such as loans, accounts, investmen ...
-
Project Scheduler
hace 6 días
SOL Engineering Services San Juan, Puerto Rico De jornada completaSOL Engineering Services, LLC is an engineering and technical services provider, with over 20 years of engineering and consulting experience. Our viability comes, in part, from utilizing the diverse backgrounds of the firm's owners and the experiences of its team of approximatel ...
-
Process Engineer
hace 3 días
HR Works San Juan, Puerto Rico ContractProcess Engineer - Laser ProcessingLocation: Dorado, PRDepartment: EngineeringThis is a contract position · Our client in the medical device manufacturing industry is committed to pioneering advanced medical solutions to enhance patient care. We specialize in developing and manuf ...
-
Cook 1
hace 6 días
FAIRMONT San Juan, Puerto RicoJob Description · Fairmont El San Juan Cook 1 is responsible for maintaining and setting up food production and quality control of all meat, fish, poultry, sauces, stocks, seasoning and all other food items prepared in the different kitchen stations. · Qualifications · QUALIFICAT ...
-
First BanCorp San Juan, Puerto RicoSALES & SERVICE REPRESENTATIVE · FIRSTBANK PR · Our Company · At FirstBank PR , we strive to be a trusted advisor to our clients and our employees are the ones that ensure we deliver on our promise of excellence in personalized customer service. Our more than 3,100 employees ...
-
Software Developer
hace 3 días
INGELLICOM San Juan, Puerto Rico De jornada completaJob Description · Professionals in the field of Information Technology (IT) with expertise in .Net Framework. Able to pay close attention to detail, develop creative solutions from complex to abstract problems with highly analytical, technologically savvy, and strong problem-solv ...
-
Sales Representative
hace 1 semana
Spectraforce San Juan, Puerto RicoContribute to the long-term growth of Nutrition products in territory by increasing awareness among Health Care Professionals on the important role of nutrition in improving quality of life. Will cover the Metro Area - from Santurce to Fajardo. To apply visit our site or send you ...
-
UI/UX Developer
hace 8 horas
INGELLICOM San Juan, Puerto Rico ContractJob Description · This position is responsible for enhancing the customer satisfaction, by improving · the usability, accessibility, and attractiveness to assist in increasing the overall · solution adoption. Provide creative solutions to UI/UX design problems by · staying up to ...
-
Project Manager- CDBG-DR
hace 8 horas
Yates Construction San Juan, Puerto RicoPosition: Project Manager · This position will be responsible for Project Management related work for commercial clients for project types including retail, multi-family, state and federal, military, gaming and hospitality, on one or multiple projects of various sizes. The indiv ...
Analyst, Product Quality - San Juan, Puerto Rico - abarca health
Descripción
What you'll do
In a few words...
Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning.
Our Quality Assurance & Oversight team is key to implementing new clients, testing claims within their respective lines of business and ensuring all claims are paying out correctly. The Quality Assurance team ensures test cases and scripts are developed on the requirements clients has specified and while designing quality review processes with other departments. Along with them, the Product Quality team leverages these skills and functions by focusing on all Abarca related products and software services by collaborating with Product Teams.
As our Product Quality Analyst you will partner with the Product Team to ensure that business requirements originating from them are developed accurately and configured into our claims adjudication platform, while the Quality Assurance Analysts and Software Testers support the development and testing. You will execute all business functional testing activities to ensure the quality of each client's pharmacy benefit design and that all new logic integrates with other plans' programs. As such, understanding those requirements, designing, and defining testing scenarios, executing them and documenting them will be an important aspect of your role. Due to the hands-on level you will take on in this role, the team will support your developing knowledge of both technical and operational sides of the business as you make recommendations on corrective actions and process improvement for testing and monitoring.
The fundamentals for the job...
What you're made of
The bold requirements...
Nice to have...
That something extra we ́d love to see...
Physical requirements...
