Description

• Bachelor's degree or Master’s Degree in Computer science, or a related field, with minimum 12+ years of experience.
• We are Looking for a  Senior QA Engineer with strong Medicaid payer and Facets expertise to independently validate state-specific regulatory implementations across Facets, Mainframe, Java, DataStage, Talend/TalendWorks, and associated applications.
• Must Analyze Medicaid regulatory requirements and develop comprehensive test scenarios for individual states.
• You should Validate end-to-end changes across: Facets, Mainframe, Java applications, DataStage, Talend/TalendWorks, APIs/interfaces, Batch systems, Upstream/downstream applications
• Must have experience with Test regulatory changes involving member enrollment, eligibility, benefits, claims adjudication, pricing, edits, and payments.
• You should Validate Mainframe and Java batch/interface processing.
• Must 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.
• Must Identify gaps between regulatory requirements, requirements documentation, technical implementation, and actual system behavior.
• Good Experience with state-specific Medicaid requirements.
• Good Medicare and Medicaid health-plan knowledge.
• Strong understanding of: Member enrollment, Eligibility, Benefits, Claims, Claims adjudication, Pricing, Payment
• Experience performing quality assessments for complex regulatory implementations

Key Skills

Education

Bachelor's or Master's degrees