Senior QA Engineer (Remote)

"Role Summary

Seeking 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.

Key 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 Business Requirement System Change Test Scenario Test Result.

Required Experience

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.