Senior QA Analyst – Healthcare Payer (Medicaid / Medicare / PBM)

Senior QA Analyst – Healthcare Payer Location Remote (USA) Employment Type Full-Time Job Summary We are seeking a Senior QA Analyst with strong experience in Healthcare Payer systems, including Medicaid, Medicare, and PBM (Pharmacy Benefit Management). The ideal candidate will be responsible for validating complex healthcare applications, ensuring high-quality releases, and supporting business-critical initiatives across claims, enrollment, eligibility, provider, and pharmacy domains.

Key Responsibilities

Analyze business and functional requirements and create comprehensive test scenarios and test cases. Perform Functional, Integration, System, End-to-End, Regression, and UAT testing. Validate Healthcare Payer applications involving: Medicaid Medicare PBM (Pharmacy Benefit Management) Claims Adjudication Member Enrollment Eligibility & Benefits Provider Management Prior Authorization Execute manual and automated testing activities. Perform API testing and backend database validation. Identify, document, and track defects through resolution. Collaborate with Business Analysts, Developers, Product Owners, and stakeholders. Participate in Agile ceremonies, including sprint planning, reviews, and retrospectives. Ensure compliance with healthcare regulations and business requirements. Required Qualifications 8+ years of QA experience with at least 5 years in the Healthcare Payer domain. Strong hands-on experience with Medicaid, Medicare, and/or PBM systems. Experience testing healthcare claims processing and adjudication systems. Expertise in: Functional Testing Integration Testing Regression Testing UAT Support API Testing Database Testing Strong SQL skills for data validation and analysis. Experience with Agile/Scrum methodologies. Excellent analytical, problem-solving, and communication skills.