Remote Position
[Remote] 100% Remote // Medicaid QA Engineer (Eligibility, Medicaid, Claims)
🌍 Remote · United States
💼 Full-time
Note: The job is a remote job and is open to candidates in USA. Talent Groups is seeking a Senior QA Engineer to independently validate state-specific Medicaid regulatory implementations. The role focuses on testing end-to-end changes across Facets and related systems, validating regulatory requirements and data, and assessing the quality of complex implementations.
Responsibilities
- Analyze Medicaid regulatory requirements and develop comprehensive test scenarios for individual states
- Validate end-to-end changes across: o Facets o Mainframe o Java applications o DataStage o Talend/TalendWorks o APIs/interfaces o Batch systems o Upstream/downstream applications
- Test regulatory changes involving member enrollment, eligibility, benefits, claims adjudication, pricing, edits, and payments
- Validate Mainframe and Java batch/interface processing
- Perform ETL and source-to-target data validation
- Conduct functional, integration, end-to-end, regression, negative, and boundary testing
- Perform independent quality assessments of regulatory solutions
- Identify gaps between regulatory requirements, requirements documentation, technical implementation, and actual system behavior
- Perform SQL-based data validation and reconciliation
- Conduct defect analysis and support root-cause investigation
- Ensure traceability across Regulation $B"\•(J Business Requirement $B"\•(J System Change $B"\•(J Test Scenario $B"\•(J Test Result
Skills
- Strong healthcare payer QA/testing experience
- Strong testing knowledge of TriZetto Facets
- Testing experience across Mainframe and Java-based applications
- Experience validating DataStage and Talend/TalendWorks processes
- SQL and database testing skills
- Strong Medicaid managed-care knowledge
- Experience with state-specific Medicaid requirements
- Good Medicare and Medicaid health-plan knowledge
- Strong understanding of: o Member enrollment o Eligibility o Benefits o Claims o Claims adjudication o Pricing o Payment
- Experience performing quality assessments for complex regulatory implementations
Benefits
- 100% remote
Company Overview
Company H1B Sponsorship