QA​/Facets Analyst

Seeking a Senior QA Engineer with strong Medicaid payer and Facets expertise to independently validate state-specific regulatory implementations across Facets, Mainframe, Java, Data Stage, Talend/Talend Works, and associated applications.

• Analyze Medicaid regulatory requirements and develop comprehensive test scenarios for individual states.
• Validate end-to-end changes across:
  • Facets
  • Mainframe
  • Java applications
  • Data Stage
  • Talend/Talend Works
  • 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.

• Strong healthcare payer QA/testing experience.
• Strong testing knowledge of Tri Zetto Facets.
• Testing experience across Mainframe and Java-based applications.
• Experience validating Data Stage and Talend/Talend Works 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:
  • Member enrollment
  • Eligibility
  • Benefits
  • Claims
  • Claims adjudication
  • Pricing
  • Payment
• Experience performing quality assessments for complex regulatory implementations.