IT Claims Quality Engineer - Remote in California

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4 Locations
In-Office or Remote
108K-184K Annually
Insurance
The Role

Our work matters. We help people get the medicine they need to feel better and live well.  We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

IT Claims Quality Engineer - Remote in CaliforniaJob Description

The Quality Engineer IT Principal is responsible for defining a roadmap for delivering Quality Shared Services to the organization; this may include leading quality engineers across a portfolio of products. Quality Shared Services includes test frameworks, test data management, performance engineering, metrics, and testing practices inclusive of the tools that support these activities. This position partners with product teams to enable quality plans, and participates in ongoing internal training, provides consulting services, and supports staffing tasks. In addition, this role leads cross functional teams to provide solutions for specific needs. We are looking for someone with a background in Pharmacy claims and claims testing. Preference to filling this role in California due to contract obligations.

Responsibilities

  • Define, communicate, and report status on the Quality Shared Services roadmap
  • Serve as thought leader, research, recommend, and drive changes as defined in roadmap
  • Present Quality Shared Services to the organization; demonstrate leadership and consensus building on Quality strategy and practices
  • Lead the definition of Quality strategy and plans for product teams; provide guidance, best practices, leadership and supervisory oversight to product team
  • Lead Community of Practice (CoP)
  • Provide metrics supporting value delivered by the Quality Shared Services
  • Lead teams in design, development, and deployment of Quality capabilities; coordinate initiatives across departments and portfolios
  • Participate with product teams to ensure consistent approaches in Quality design
  • Lead Quality Excellence Center (QEC) activities for metrics, training, recruiting, staffing, and career planning activities
  • Other duties as assigned

Education & Experience

  • Bachelor's degree in Information Technology or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
  • 8 years of experience in software testing including software automation
  • Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

  • Strong testing, problem-solving, and systems analysis skills
  • Advanced ability in writing proposals and quality assurance testing reports; presentation skills
  • Ability to work in a fast-paced environment with tight deadlines and changing priorities
  • Ability to work independently on multiple concurrent projects and manage priorities
  • Self-driven team player; shows initiative
  • Advanced knowledge of testing practices, methods, standards, and tools
  • Proficient in leveraging test management tools to include reports and dashboards
  • Ability to design, develop, coordinate, and document needed testing capabilities required for complex/integrated application business solutions

Preferred Qualifications

  • Experience with Test Data Management, test automation and/or performance testing
  • High level of proficiency in using SQL
  • ETL Process experience
  • Interface testing experience
  • Experience writing QA/Testing related proposals, presentations, and status reports
  • Certification in software testing or quality assurance
  • Experience driving and/or maintaining IT department technical improvements, initiatives
  • Previous experience working at a PBM and with Pharmacy Claims
  • Experience with UNIX Operating System
  • Previous experience with Claims Testing

Physical Demands

  • Ability to work a flexible schedule including shifts outside of Prime's core business hours of 9:00 a.m. to 3:00 p.m.
  • Constantly required to sit, use hands to handle or feel, talk and hear
  • Frequently required to reach with hands and arms
  • Occasionally required to stand, walk and stoop, kneel, and crouch
  • Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
  • Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

Potential pay for this position ranges from $108,000.00 - $184,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.   

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.

Prime Therapeutics Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Prime Therapeutics and has not been reviewed or approved by Prime Therapeutics.

  • Healthcare Strength Health coverage is described as comprehensive, with medical, dental, and vision options and plan designs that include low deductibles for some choices. Wellness screenings and related incentives add perceived value to the health offering.
  • Retirement Support Retirement benefits stand out through a 401(k) match that is characterized as generous and immediately vested. This structure improves the overall long-term value of the total rewards package.
  • Strong & Reliable Incentives Annual incentive bonuses are positioned as a meaningful component of total compensation and are often portrayed as substantial when performance goals are met. Incentive eligibility appears broadly available across roles, boosting the perceived completeness of rewards.

Prime Therapeutics Insights

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The Company
HQ: Eagan, MN
3,577 Employees
Year Founded: 1987

What We Do

Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 20 years. In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 28+ million members throughout the US. In addition to core PBM services, we work closely with our clients to implement the right benefit design, clinical and specialty programs, formulary and networks. A few key products: • NetResults™ • Specialty Drug Management • Best in Care™ • GuidedHealth® • Advanced Fraud, Waste and Abuse: Member and Prescriber Investigations • Prime Analytics™ • CareCentered Contracting™Controlled Substance Management Program Join us! Prime is always looking for smart, purposeful people to join our team. We’re growing fast which means there are plenty of opportunities to advance and grow in your career. At the same time, Prime supports flexibility and offers generous PTO so you can enjoy an enviable work/life balance. We’re a privately held company -big enough to make a difference and small enough for you to have an impact. Follow Prime on LinkedIn to learn more.

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