Remote Position
[Remote] Senior QA - Facets & Medicaid Regulatory Solutions
🌍 Remote · United States
💼 Full-time
Note: The job is a remote job and is open to candidates in USA. AppLab Systems is recruiting for a client seeking a Senior QA Engineer with Medicaid payer and Facets expertise. The role independently validates state-specific regulatory implementations across Facets and connected platforms, including Mainframe, Java, and ETL processes.
Responsibilities
- Analyze Medicaid regulatory requirements and develop comprehensive test scenarios for individual states
- Validate end-to-end changes across:
- Facets
- Mainframe
- Java applications
- DataStage
- Talend/TalendWorks
- APIs/interfaces
- Batch systems
- 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 → Business Requirement → System Change → Test Scenario → 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
- Member enrollment
- Eligibility
- Benefits
- Claims
- Claims adjudication
- Pricing
- Payment
- Experience performing quality assessments for complex regulatory implementations
- Strong Facets + Medicaid + end-to-end cross-platform testing, with ability to validate Mainframe/Java/ETL processing
Benefits
- Remote
Company Overview
Company H1B Sponsorship