Senior QA - Facets & Medicaid Regulatory Solutions

Role
:
Senior QA Engineer – Facets & Medicaid Regulatory Solutions

Location
:
Remote

Type
:
Contract/FTE

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, Data Stage, Talend/Talend Works, and associated applications.

Key Responsibilities:

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

Required 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:

• Claims
• Claims adjudication
• Payment
• Experience performing quality assessments for complex regulatory implementations.

Mandatory: Strong Facets + Medicaid + end-to-end cross-platform testing, with ability to validate Mainframe/Java/ETL processing.