Manager, IT Testing – Claims Domain

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $97.8k - $127k / year

⏰ Full Time

🟠 Senior

🔴 Lead

💻 IT Support

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Conduent

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2017

🤝 B2B

☁️ SaaS

🏢 Enterprise

💰 $93M Post-IPO Debt - Conduent on 2025-08

B2B • SaaS • Enterprise

Conduent is...

📋 Description

• Serve as Claims Domain Test Manager for MMIS health care projects • Drive test strategy, testing processes, and claims-domain knowledge • Analyze business requirements and design and develop test plans • Ensure quality processes throughout the project lifecycle • Coordinate with customers on delivery and deployments • Provide testing guidance throughout the entire life cycle • Meet customer expectations and troubleshoot application problems • Assist customers with implementation decisions • Work closely with clients and development teams during development stages • Conduct milestone-completion demos and track and close demo feedback • Collaborate with development, architecture, and design teams to define GUI views and platform requirements • Validate the end-to-end flow from claim intake through payment and reporting • Test integration points between systems • Design test cases based on business rules, coverage policies, and system configurations • Validate backend data using SQL, including claim status, payment details, members, providers, and benefit plans • Validate EDI X12 files and test interfaces/APIs using tools such as Postman • Review requirements and documentation and create Requirements Traceability Matrices • Create test plans, test summary reports, and traceability matrices • Assess current product functionality against market trends and regulatory requirements for future product versions • Drive and communicate product-feature requirements with technical and architecture teams • Collaborate with cross-functional teams including developers, SMEs, and BAs

🎯 Requirements

• Strong health care domain experience, especially in the MMIS domain • Good knowledge of Medicaid and Medicare • Hands-on experience with claims processing and adjudication processes • Experience with reference codes/data sets required in claims adjudication • Experience or understanding of configuring benefits or programs in claims systems across various subsystems • Ability to run queries and perform basic system analysis and root-cause analysis (RCA) • Excellent written and spoken communication skills • Ability to multitask between internal teams and clients based on priority tasks • In-depth understanding of claims and claims lifecycle, including member, provider, paper and EDI X12 claim submission, adjudication, payment cycle, and reporting • Knowledge of professional, dental, institutional, pharmacy, encounter, and capitation claim types • Knowledge of EDI X12 formats including 837P/I/D, 835, 834, 270/271, and 276/277 • Familiarity with claims systems such as CMdS, GHS, and Facets • Familiarity with test management tools such as ADO and JIRA • Familiarity with interface/API testing tools such as Postman • Minimum of 10+ years of health care experience, especially in the MMIS domain • SQL for backend data validation • EDI tools for validating X12 files • Understanding of data flows between systems and formats for interface testing • Ability to validate test scenarios, test plans, and test data • Ability to review requirements and documentation and create Requirements Traceability Matrices (RTM) • Ability to assess product functionality against market trends and regulatory requirements • Ability to drive and share requirements with technical and architecture teams • Experience creating test plans, test summary reports, and traceability matrices • Ability to collaborate with developers, SMEs, BAs, QA teams, clients, end users, and business units

🏖️ Benefits

• Bonus or incentive eligibility based on business need • Health insurance coverage • Voluntary dental and vision programs • Life and disability insurance • Retirement savings plan • Paid holidays • Paid time off (PTO) or vacation and/or sick time • Reasonable accommodation for applicants with disabilities