Test Lead II – Healthcare Payer Testing

🕒 il y a 7 jours

🇺🇸 États-Unis – Télétravail

💵 $90 000 - $120 000 / an

⏰ Temps Plein

🟠 Senior

🗣️🇺🇸🇬🇧 Anglais requis

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Logo of HealthEdge

HealthEdge

1001 - 5000 employés

Fondée en 2005

🏥 Santé

💼 Conseil

⚕️ Assurance santé

Healthcare • Consulting • Healthcare Insurance

HealthEdge est une entreprise spécialisée dans la fourniture de solutions avancées pour les gestionnaires de soins de santé grâce à sa suite HealthRules Solutions. Cette suite comprend un système complet de traitement administratif des réclamations numériques, des solutions de gestion des workflows de soins et des solutions d'intégrité des paiements, visant à améliorer l'efficacité opérationnelle et la qualité des soins pour les régimes de santé. En tirant parti de la technologie intégrée et de l'automatisation, HealthEdge aide les régimes de santé à éliminer les silos de données, à accroître la précision des paiements et à améliorer l'expérience des membres, transformant ainsi le paysage des soins de santé pour une meilleure collaboration et accessibilité.

Description

• Develop detailed test cases, scenarios, and scripts for claims processing, enrollment, benefits, provider data, and EDI transaction flows • Lead functional, integration, regression, and UAT cycles for assigned payer modules • Analyze requirements and business rules to identify gaps, ambiguities, and testability issues before execution • Own defect lifecycle management, including logging, triage, root cause classification, retesting, and closure tracking • Validate EDI transactions (834, 837, 835, 270/271, 820) against payer business rules and X12 standards • Support compliance and regulatory test cycles, including ICD updates, CMS mandates, and state-specific Medicaid rules • Coordinate with developers, business analysts, and configuration teams to resolve blockers and clarify expected behavior • Produce daily and weekly execution status reports with defect metrics, coverage status, and risk flags • Manage offshore QA analysts • Collaborate closely with the Test Manager and cross-functional delivery teams

🎯 Exigences

• 5+ years in software QA/testing • 2+ years in a lead or senior tester role • Solid experience testing U.S. healthcare payer systems, including claims, enrollment, benefits, or provider network • Working knowledge of EDI X12 transactions and HIPAA compliance requirements • Hands-on test case design experience using boundary analysis, equivalence partitioning, and negative testing techniques • Proficiency in defect tracking and test management tools such as JIRA, Zephyr, ALM, or equivalent • Ability to read and interpret payer business rules, EOPs, benefit plan documents, and SLAs • Strong attention to detail • Candidates may be required to undergo a pre-employment criminal background check

🏖️ Avantages

• Remote work arrangement • Working hours aligned to Eastern Standard Time • Up to 5% travel • Reasonable accommodations for individuals with disabilities • Equal opportunity employment • Workforce diversity and inclusion

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