Pharmacy Testing Manager (PBM/Medicaid)

Gainwell Technologies LLC•Any city, OH

40d•$86,700 - $123,900•Remote

About The Position

The Pharmacy Testing Manager (PBM/Medicaid) leads end-to-end testing for pharmacy solutions, including system integration testing (SIT), user acceptance testing (UAT), regression, parallel testing, and production validation. The role ensures quality delivery of pharmacy benefit management (PBM) and Medicaid solutions and alignment with business requirements, CMS guidelines, and state Medicaid regulations. The manager develops and oversees test strategies, plans, schedules, and execution governance; leads functional validation across pharmacy claims and financial processes; coordinates defect management and cross-functional testing readiness; and reports quality metrics, risks, issues, and progress to stakeholders. This is a fully remote opportunity within the U.S., with occasional travel of 0–10%.

Requirements

10+ years of software testing experience.
5+ years of Test Management experience.
Strong PBM or Medicaid pharmacy experience.
Experience with large-scale DDI or MMIS modernization programs.
Expertise in claims adjudication, NCPDP transactions, prior authorization, formulary management, drug rebate processing, and pharmacy financial validation.
Experience using ALM/JIRA and SQL for data validation.

Responsibilities

Lead end-to-end pharmacy testing across SIT, UAT, regression, parallel testing, and production validation.
Develop and manage test strategy, plans, schedules, and execution governance in alignment with business requirements, CMS guidelines, and state Medicaid regulations.
Oversee functional validation of claims adjudication, drug pricing, formulary management, prior authorization, rebates, NCPDP transactions, and financial reconciliation processes.
Manage defects and coordinate business SMEs, vendors, developers, conversion teams, and testing resources to support timely issue resolution and testing readiness.
Provide leadership reporting and stakeholder communications by tracking quality metrics, risks, issues, and test progress.