Quality Assurance Engineer

This is a fully remote position, open to applicants in United States.

📋 Description

• Collaborate with IT, Operations, Configuration, EDI, Reporting, Business Analysts, and various cross-functional stakeholders to ensure comprehensive testing of system changes prior to deployment.

• Design, construct, and uphold non-production testing environments that accurately replicate end-to-end managed care workflows and system interactions.

• Create and manage test data libraries encompassing provider, member, eligibility, authorization, referral, claims, pricing, payment, reporting, and data exchange workflows.

• Implement procedures for refreshing, validating, and overseeing test data while ensuring compliance with regulatory and privacy standards.

• Coordinate the readiness of environments and testing timelines across various projects and releases.

• Supervise testing environments for availability, stability, and data integrity.

• Formulate test strategies, plans, scripts, and cases for enhancements, APIs, interfaces, integrations, regulatory workflows, and production fixes.

• Carry out functional, regression, integration, user acceptance, and end-to-end testing.

• Validate system logic, master data, configuration, benefit rules, provider data, authorization and referral workflows, claims adjudication, payment processes, reporting outputs, and downstream integrations.

• Confirm system behavior aligns with business requirements and operational specifications.

• Implement risk-based testing rooted in business impact, operational risk, and regulatory requirements.

• Validate functionalities pertaining to HIPAA, CMS requirements, interoperability mandates, delegated services, and other relevant regulations.

• Identify, document, prioritize, and monitor defects until resolution.

• Investigate root causes and verify fixes in collaboration with developers, analysts, and operational stakeholders.

• Retest defects and confirm remediation prior to production deployment.

• Serve as a liaison between IT and operational teams during testing activities.

• Convert business requirements and operational workflows into testing scenarios.

• Suggest enhancements to QA methodologies, testing tools, automation possibilities, and release management processes.

• Design, develop, and sustain automated test scripts.

• Assist in production issue investigations and post-implementation validation.

• Provide updates on testing status, risk assessments, and defect summaries to project teams and leadership.

• Uphold testing standards, procedures, and documentation repositories.

• Develop QA metrics and dashboards that measure testing effectiveness and release quality.

⛳️ Requirements

• Bachelor's degree in Information Technology, Computer Science, Information Systems, Healthcare Administration, Business, or a related field, or equivalent professional experience.

• A minimum of 3 years of experience in software quality assurance or software testing.

• Background in supporting healthcare technology platforms, managed care operations, payer systems, provider network systems, claims processing platforms, or similar enterprise applications.

• Proven experience in creating test plans, test scripts, and executing structured testing methodologies.

• Familiarity with Agile, Waterfall, or hybrid project environments.

• Knowledge of healthcare interoperability standards including FHIR, HL7, X12, and API-based integrations.

• Experience validating CMS interoperability and prior authorization workflows.

• Strong comprehension of the software development lifecycle (SDLC) and quality assurance practices.

• Excellent analytical and problem-solving capabilities.

• Exceptional attention to detail and documentation skills.

• Ability to juggle multiple priorities and deadlines simultaneously.

• Strong verbal and written communication abilities.

• Capacity to collaborate effectively with both technical and non-technical stakeholders.

• Proficient in Microsoft Office Suite, especially Excel.

• Technical knowledge of APIs, interfaces, and system integrations.

• Working knowledge of SQL for data validation, troubleshooting, and root cause analysis.

• Experience utilizing defect tracking and test management tools.

• Preferred: familiarity with managed care, payer administration, provider network, care management, authorization, claims, or related healthcare enterprise platforms.

• Preferred: experience with SQL and database validation.

• Preferred: experience with test automation tools.

• Preferred: exposure to AI-enabled testing tools.

• Preferred: understanding of EDI transactions, including 837 and 835 files.

• Preferred: experience in healthcare payer, TPA, managed care, delegated services, provider network, utilization management, or specialty benefit management.

• Preferred: QA certifications such as ISTQB, CSTE, or equivalent.

🏝️ Benefits

• Remote work arrangement.

• Flexible candidate location within the U.S.