Test Lead, Manual Test, US Healthcare, Medicaid, Pharmacy

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

📋 Description

• Conduct essential testing, troubleshooting, and analysis of application software for intricate technical projects.

• Design, develop, execute, maintain, and oversee critical testing processes.

• Collect testing requirements, create actionable test cases, and assist in distributing tasks among a team of test engineers.

• Coordinate and collaborate with team members to analyze requirements, confirm, identify, and communicate defect-causing issues to the appropriate stakeholders.

• Provide assistance, as necessary, in drafting proposals to recommend processes and programs.

• Aid in preparing estimates for carrying out the various activities outlined in the test plan.

⛳️ Requirements

• Over 15 years of overall professional experience.

• More than 5 years specifically in Medicaid pharmacy operations, MMIS/MES systems, PBM functionalities, or pharmacy claims processing.

• In-depth understanding of NDC, HCPCS, quantity limits, and drug pricing methodologies.

• Strong grasp of Medicaid PDL, clinical PA criteria, and DUR requirements.

• Comprehensive knowledge of pharmacy benefit administration and reimbursement models.

• Practical experience with EDI transactions (837, 835, 278).

• Proficiency with test management tools and SQL for data validation purposes.

• Familiarity with Gainwell, Conduent, Optum, Magellan, or other Medicaid pharmacy modules.

🏝️ Benefits

• Flexible work arrangements.