Client Services Business Quality Assurance Analyst II - Medicaid Fee For Service

About the role

The Client Services Business Quality Assurance Analyst II - Medicaid FFS serves as a subject matter expert in benefit configuration and quality assurance across MedImpact's PBM programs. This role leads complex validation efforts, oversees quality and compliance review activities, and ensures that configuration, operational processes, and deliverables meet client requirements and internal quality standards. Operating with a high degree of independence, this position drives continuous 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. Lead the design, execution, and oversight of complex configuration validation activities for benefit, pharmacy network, and formulary administration in pre‑production environments. Apply advanced Configuration Services best practices to develop comprehensive test plans, data sets, test scenarios, expected results, and acceptance criteria. Validate configuration accuracy for maintenance of business, new client implementations, regulatory updates, and special projects. 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 complex or unique benefit requests and ensure accurate migration of validated changes from Test to Production environments. Develop, refine, and execute quality assurance procedures to ensure operational compliance with PBM standards and client requirements. Lead quality and compliance review projects, including test execution, documentation of results, and development of corrective action plans. Participate in internal and external audits of PBM services, ensuring findings are addressed promptly and effectively. Perform high‑volume data testing across multiple file types to validate accuracy, completeness, and regulatory compliance. Serve as a senior liaison to internal operational teams and external clients to improve the quality and compliance of PBM program implementations and ongoing operations. Respond to complex inquiries regarding quality review outcomes, compliance requirements, and configuration validation processes. Communicate significant issues, risks, and improvement opportunities to leadership, ensuring visibility and timely resolution. Champion continuous quality improvement initiatives by identifying process gaps, recommending enhancements, and supporting implementation of efficiency improvements. Mentor and coach Testing & Validation Analysts and Quality Analysts, providing guidance on test design, analysis techniques, regulatory interpretation, and best practices. Contribute to the evolution of departmental methodologies, tools, and documentation to strengthen organizational quality and validation capabilities. 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.

Requirements

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Th

Benefits

Additional Information

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. MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team! Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare. At MedImpact, 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

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