Test Lead II - Healthcare Payer Testing

HealthEdge • Remote,

1d • $90,000 - $120,000 • Remote

About The Position

HealthEdge is seeking a Test Lead II with healthcare payer domain expertise to drive test planning and execution for payer system engagements. This hands-on role owns test case design, defect management, and daily execution quality while collaborating with the Test Manager and cross-functional delivery teams. The role also manages offshore QA analysts. The position is remote, works Eastern Standard Time hours, and may require up to 5% travel.

Requirements

• At least 5 years of software QA/testing experience.
• At least 2 years in a lead or senior tester role.
• Solid experience testing U.S. healthcare payer systems, including claims, enrollment, benefits, or provider networks.
• 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 with defect tracking and test management tools such as JIRA, Zephyr, ALM, or equivalent.
• Ability to read and interpret payer business rules, EOPs, benefit plan documents, and SLAs.
• Strong attention to detail.

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 to identify gaps, ambiguities, and testability issues before execution begins.
• Manage the defect lifecycle, including logging, triage, root cause classification, retesting, 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, including ICD updates, CMS mandates, and state-specific Medicaid rules.
• Coordinate with developers, business analysts, and configuration teams to resolve blockers and clarify expected behavior.
• Produce daily and weekly execution status reports with defect metrics, coverage status, and risk flags.
• Manage offshore QA analysts.

What This Job Offers

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