We are seeking an experienced Technical Test Lead / Quality Engineering Lead with strong expertise in US healthcare payer systems, Medicaid claims adjudication, provider affiliation, and provider contracting. The ideal candidate will have hands-on experience with QNXT, FACETS, or similar healthcare platforms, along with expertise in manual testing, test automation, test planning, and execution.
Key Responsibilities
- Lead test planning, test strategy development, test scripting, execution, and defect management.
- Validate Medicaid provider affiliation, provider relationships, provider demographics, and contracting workflows in QNXT, FACETS, or similar platforms.
- Test provider contract setup, updates, terminations, and related functionalities across contracting applications.
- Validate EDI 837 healthcare claims processing and adjudication for Medicaid plans.
- Verify provider contracts and provider relationships affecting claims adjudication.
- Test commercial healthcare plans, provider classifications, specialties, and related business rules.
- Perform manual testing and mobile UI test automation planning and execution as applicable.
- Analyze business requirements and prepare test scenarios, test cases, and test data.
- Track and manage defects using JIRA and other test management tools.
- Prepare test plans, test scripts, test results, execution reports, and status updates.
- Conduct test result walkthroughs and demonstrations for clients and business stakeholders.
- Communicate testing progress, risks, issues, and quality metrics effectively.
- Ensure adherence to software testing methodologies, quality standards, and project timelines.
Required Skills and Qualifications
- Strong experience in US healthcare payer/provider domains, particularly provider affiliation, demographics, and contracting.
- Hands-on knowledge of Medicaid claims adjudication using QNXT, FACETS, or similar healthcare platforms.
- Experience testing EDI 837 claims processing and adjudication.
- Knowledge of commercial healthcare plans and provider network management.
- Experience with provider contract setup, maintenance, updates, and termination workflows.
- Strong understanding of manual testing methodologies and test lifecycle management.
- Experience in test planning, test case development, test execution, defect tracking, and reporting.
- Familiarity with mobile application testing and mobile UI test automation.
- Experience with JIRA and Rational test management tools.
- Excellent communication, analytical, and stakeholder management skills.