[Hiring] Test Lead - Healthcare Payer Testing @HealthEdge

Role Description

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.

Key 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.
• Manage offshore QA analysts.

Qualifications

• 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.

Requirements

• Remote, US.
• Full-time, permanent.
• Exempt (FLSA Classification, USA Only).

Work Environment

• The employee is occasionally required to move around the office.
• Specific vision abilities required include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
• Work across multiple time zones in a hybrid or remote work environment.
• Long periods of time sitting and/or standing in front of a computer using video technology.
• May require travel dependent on company needs.

Benefits

• The annual US base salary range for this position is $100,000 to $120,000.
• This salary range may cover multiple career levels at HealthEdge.
• Final compensation will be determined during the interview process based on a combination of factors including skills, experience, qualifications, and education.

Company Description

HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans, and persons with disabilities.