Gainwell Technologies
10,000+ employees
⚕️ Healthcare Insurance
💰 Grant on 2023-06
Healthcare Insurance • Human Services • Healthcare
Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.
Test Lead, Manual Test, US Healthcare, Medicaid, Pharmacy
🔥 0 minutes ago
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Gainwell Technologies
10,000+ employees
⚕️ Healthcare Insurance
💰 Grant on 2023-06
Healthcare Insurance • Human Services • Healthcare
Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.
📋 Description
• Perform vital testing, troubleshooting and analysis of application software for complex technical projects • Design, develop, implement, maintain and monitor critical test processes • Gather requirements for testing, develop executable test cases and help distribute workload across a team of test engineers • Coordinate and collaborate with others to analyze requirements to confirm, establish and communicate the defect-causing problem to the right stakeholders • Assist, as needed, in writing proposals to recommend process and programs • Help prepare estimates for performing the various activities defined in the test plan
🎯 Requirements
• 15+ years of overall experience • 5+ years specifically in Medicaid pharmacy operations, MMIS/MES systems, PBM functions, or pharmacy claims processing • Strong understanding of NDC, HCPCS, quantity limits, and drug pricing methodologies • Strong understanding of Medicaid PDL, clinical PA criteria, DUR requirements • Strong understanding of Pharmacy benefit administration and reimbursement models • Hands‑on experience with EDI transactions (837, 835, 278) • Experience with test management tools and SQL for data validation • Familiarity with Gainwell, Conduent, Optum, Magellan, or other Medicaid pharmacy modules
🏖️ Benefits
• Flexible work arrangements
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