Test Lead - Healthcare Payer Testing

HealthEdge • Remote,

1d • $100,000 - $120,000 • Remote

About The Position

We are seeking a Test Lead with healthcare payer domain expertise to drive test planning and execution for payer system engagements. This role is hands-on — you own test case design, defect management, and daily execution quality while collaborating closely with the Test Manager and cross-functional delivery teams.

Requirements

• 5+ years in software QA/testing
• 2+ years in a lead or senior tester role
• Solid experience testing U.S. healthcare payer systems — claims, enrollment, benefits, or provider network
• Working knowledge of EDI X12 transactions and HIPAA compliance requirements
• Hands-on test case design experience using boundary analysis, equivalence partitioning, and negative testing techniques
• Proficiency in defect tracking and test management tools (JIRA, Zephyr, ALM, or equivalent)
• Ability to read and interpret payer business rules, EOPs, benefit plan documents, and SLAs
• Strong attention to detail — payer system defects have financial and compliance consequences

Responsibilities

• Develop detailed test cases, scenarios, and scripts for claims processing, enrollment, benefits, provider data, and EDI transaction flows
• Lead functional, integration, regression, and UAT cycles for assigned payer modules
• Analyze requirements and business rules — identify gaps, ambiguities, and testability issues before execution begins
• Own defect lifecycle management: logging, triage, root cause classification, retest, and closure tracking
• Validate EDI transactions (834, 837, 835, 270/271, 820) against payer business rules and X12 standards
• Support compliance and regulatory test cycles — ICD updates, CMS mandates, state-specific Medicaid rules
• Coordinate with developers, BAs, and configuration teams to resolve blockers and clarify expected behavior
• Produce daily/weekly execution status reports with defect metrics, coverage status, and risk flags
• Manages offshore QA analysts.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed