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Risk Adjustment Quality Assurance Analyst - REMOTE



IT, Quality Assurance
Boston, MA, USA
Posted on Thursday, October 12, 2023

Welcome to Veradigm! Our Mission is to be the most trusted provider of innovative solutions that empower all stakeholders across the healthcare continuum to deliver world-class outcomes. Our Vision is a Connected Community of Health that spans continents and borders. With the largest community of clients in healthcare, Veradigm is able to deliver an integrated platform of clinical, financial, connectivity and information solutions to facilitate enhanced collaboration and exchange of critical patient information.

Position Description

The Senior Quality Assurance Analyst will act as product SME and work collaboratively with development and product teams to ensure a high level of data accuracy related to products delivered to our customers. The Sr. Quality Assurance Analyst will lead and enhance a comprehensive quality assurance program and provide full review and approval of data content related to new development, product enhancements and client production runs.

Location: REMOTE


Develop and Maintain a Robust Quality Assurance Program

  • Solidify and improve the current quality assurance program supporting the data integrity and accuracy of our client deliverables
  • Maintain the policies and procedures that govern the quality review and approval of client facing data
  • Work collaboratively with the Risk Adjustment Analytics team to share and capture best practices to support continuous improvement of the Risk Adjustment program

Support Development and Product Teams

  • Work closely with the innovations development and product teams to ensure the data quality assurance process is in place and adhered to including: new customer implementation QA, Integrated and Regression testing of updated code deployments, monthly customer production deliverables QA and continuous process improvement
  • Develop and maintain test cases, acceptance criteria and automation to ensure adequate testing of data content and quality prior to providing customer access to deliverables and dashboards
  • Perform quality assurance tests based on test cases and acceptance criteria
  • Document and report out any issues found and work collaboratively with the nnovations development and product team to make necessary corrections

Qualifications and Experience

  • 3-5 years of experience analyzing Medicare Advantage (MA), Affordable Care Act (ACA) and/or Medicaid plan data related to:
    • Medical, pharmacy, eligibility, and lab data
    • CMS Risk Adjustment models
    • HEDIS, 5-Star or QRS measure reporting and analysis
  • 3+ years of experience providing Integrated and Regression quality assurance acceptance testing for data integrity and accuracy of output data changes related to new code deployment
  • 3+ years of advanced MS-SQL Server query writing and analysis
  • Strong in test plan and business requirements documentation
  • Ability to work within a remote team environment
  • Experience with SAS a plus

Academic and Professional Qualifications

  • BA or BS degree preferred and/or other relevant combination of training experience and industry experience – healthcare analytics, information systems, hospital administration, quality assurance


We strongly advocate that our associates receive all CDC recommended vaccinations in prevention of COVID-19.

Visa Sponsorship is not offered for this position.

Veradigm’ policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Veradigm must be legally authorized to work in the United States. Verification of employment eligibility will be required as a condition of hire. Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.

From a "VEVRAA Federal Contractor" We request Priority Referral of Protected Veterans

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