Quality Review and Audit Advisor - Express Scripts - Hybrid

POSITION SUMMARY

The Quality Review and Audit Advisor is responsible for complex and large-scale/cross-functional testing projects and initiatives including but not limited to end-to-end benefit testing and implementation support management with a strong emphasis on process and client setup knowledge and internal and external communications.

The role exists within a fast-paced and dynamic team whose focus is to collaborate and empower each other to deliver complex implementations, benefit changes, and enterprise projects on time .

The Quality Review and Audit Advisor will collaborate with various business operational stakeholders and Centene to ensure an adequate test plan is in place and executed to test and validate client testing requirements .

The team is responsible for confirming accurate benefit setup through testing to best position Centene, its members, and those who support them for success.

The Advisor will drive internal and enterprise-focused projects to deliver continuous improvement by collaborating with stakeholders, managing and delivering on critical milestones, and implementing changes with needed documentation and communication.

This role supports Centene Medicare, Medicaid, and Exchange (HIM) lines of business with an emphasis on benefits, clinical, and network configuration and is client-facing.

Essential Responsibilities, Skills, and Attributes For Success



* Lead or co-lead implementation testing of new Centene implementations and existing business changes and initiatives



* Work directly with Centene, PMO, Account Teams, Client Service Teams, Operations, and Product partners to understand client setup/intent, testing scenarios meet client expectations, deadlines, impacts/changes to ensure delivery of client contractual testing requirements drive overall client satisfaction.



* Create, review, and confirm testing data for quality and accuracy



* Ensure the execution of the business testing is completed within the expected completion date.



* Communicate status and risk to Centene Benefit Validation and Testing leadership.



* Ensure defects/issues are documented tracked and escalated to appropriate teams .

Support solutions to issues/defects to drive optimal outcomes.



* Report on business testing status.



* Attend and participate in project status, client calls, and ad hoc meetings.



* Develop ongoing quality controls and testing procedures that can be reused for projects, implementations, or maintenance of business changes.



* Support lessons learned.

Provide recommendations to improve processes and contribute to ongoing process improvements within the role.



* Support pilot initiatives, and projects which drive department strategy and client satisfaction as well as other responsibilities as directed.



* Work with team leadership to identify opportunities for process improvement within the tools and the processes we use, including those coordinated with o...