Test Lead – Healthcare Payer Testing

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

📋 Description

• Create comprehensive test cases, scenarios, and scripts for claims processing, enrollment, benefits, provider data, and EDI transaction workflows.

• Oversee functional, integration, regression, and UAT cycles for designated payer modules.

• Evaluate requirements and business rules — pinpoint gaps, ambiguities, and testability concerns prior to execution.

• Manage the defect lifecycle, including logging, triage, root cause analysis, retesting, and closure tracking.

• Verify EDI transactions (834, 837, 835, 270/271, 820) against payer business rules and X12 standards.

• Assist in compliance and regulatory testing cycles — including ICD updates, CMS mandates, and state-specific Medicaid regulations.

• Collaborate with developers, BAs, and configuration teams to address blockers and clarify expected behaviors.

• Generate daily/weekly execution status reports featuring defect metrics, coverage status, and risk indicators.

• Supervise offshore QA analysts.

⛳️ Requirements

• 5+ years of experience in software QA/testing.

• 2+ years in a leadership or senior tester capacity.

• Extensive background in testing U.S. healthcare payer systems — including claims, enrollment, benefits, or provider networks.

• Familiarity with EDI X12 transactions and HIPAA compliance requirements.

• Practical experience in test case design utilizing boundary analysis, equivalence partitioning, and negative testing methodologies.

• Proficiency in defect tracking and test management tools (JIRA, Zephyr, ALM, or similar).

• Capability to read and interpret payer business rules, EOPs, benefit plan documents, and SLAs.

• Keen attention to detail — understanding that defects in payer systems can have financial and compliance implications.

🏝️ Benefits

• HealthEdge is an equal opportunity employer.

• Dedicated to fostering workforce diversity.