QA Lead (PBM/Healthcare Domain)

American IT Systems•Plano, TX

2d•Hybrid

About The Position

We are seeking an experienced QA Lead with strong expertise in Pharmacy Benefit Management (PBM) and Healthcare testing. The ideal candidate will lead quality assurance initiatives across UI, API, functional, integration, regression, and end-to-end testing efforts while ensuring high-quality delivery of PBM applications and business workflows.

Requirements

Strong experience in PBM (Pharmacy Benefit Management) modules including: Member Eligibility, Benefit Plan Configuration, Formulary Management, Pharmacy POS Claims, Claims Adjudication, Prior Authorization, Utilization Management, Pricing Accumulators, Pharmacy Networks, Payment & Settlement, Reporting.
API Testing: Postman, SoapUI, Swagger/OpenAPI, REST Assured, Newman
API & Integration Knowledge: REST APIs, SOAP Services, JSON, XML, HTTP Methods, Authentication & Authorization, Response Validation, Status Codes & Error Handling
UI Testing: Web Portal Testing, Browser Validation, Member, Provider, and Pharmacy Workflows, Admin Portal Testing
Database Testing: SQL Queries, Data Validation, Data Reconciliation
Backend Verification
Reporting Validation
Test Management Tools: Jira, Azure DevOps, ALM/Quality Center, TestRail, qTest
Bachelor's Degree in Computer Science, Information Technology, Engineering, or a related field.

Nice To Haves

Automation Tools (Preferred): Selenium, Playwright, Cypress
API Automation Frameworks
Experience leading QA teams in Healthcare/PBM environments.
Strong understanding of test automation framework design principles.
Experience working in Agile/Scrum environments.
Knowledge of AI-driven testing frameworks and intelligent test automation.
Excellent communication, stakeholder management, and leadership skills.
ISTQB Certification
Certified Scrum Master (CSM)
Healthcare/PBM Domain Certifications

Responsibilities

Lead and manage QA activities across PBM/Healthcare projects.
Validate PBM business workflows through functional, integration, regression, and end-to-end testing.
Design and review test strategies, test plans, test cases, and execution reports.
Collaborate with business analysts, developers, product owners, and stakeholders to ensure quality deliverables.
Develop and maintain automation frameworks following modular, reusable, and scalable design principles.
Perform API, UI, database, and backend validation testing.
Manage defect lifecycle including logging, triage, tracking, retesting, and closure.
Ensure comprehensive test coverage and maintain traceability across requirements.
Support release validation and production readiness activities.
Drive quality improvements through automation and AI-driven testing methodologies.