[Remote] QA -  Facets with Java/Mainframe – Medicaid Regulatory Solutions and Payer

Note: The job is a remote job and is open to candidates in USA. Confidential is seeking a QA professional for Medicaid regulatory and payer solutions. The role calls for expertise in Facets, Java or Mainframe, and integrations across healthcare payer systems and processes.

Skills

• Deep hands-on expertise in Mainframe or Java, plus strong Facets, and integration knowledge
• Candidates should have strong knowledge of Medicaid managed-care operations and experience working with state-specific Medicaid requirements
• They should understand how regulatory changes affect member enrollment/eligibility, coverage, claim processing, authorization, pricing/payment, data and downstream health-plan operations
• They should also possess a good working understanding of Medicare and Medicare-Medicaid processes
• Candidates must have experience delivering healthcare payer solutions across a combination of TriZetto Facets, Mainframe, Java/J2EE, IBM DataStage, Talend/TalendWorks, databases, batch processing, APIs and system integrations
• Candidates should have strong knowledge of Medicaid managed-care processes and state-specific regulatory requirements, together with a good understanding of Medicare and Medicaid health-plan operations, particularly member enrollment, eligibility, benefits, claims adjudication, pricing and payment

Benefits

• Remote work (USA)

Company Overview

Company H1B Sponsorship