Healthcare QA Test Manager – Facets Claims

About The Role

As a Healthcare QA Test Manager – Facets Claims, you will make an impact by ensuring the quality, accuracy, and reliability of healthcare claims processing solutions within large-scale Facets transformation and migration initiatives. You will be a valued member of the Quality Engineering team and work collaboratively with business stakeholders, Facets configuration teams, developers, and sing teams to deliver high-quality healthcare payer solutions.

Responsibilities

• Perform end-to-end sing of Facets Claims processing applications to ensure accurate claim adjudication and business rule execution.
• Execute large-scale parallel sing by comparing Legacy and Facets claims processing results and identifying discrepancies.
• Validate Medicare claims processing workflows, configuration changes, and business requirements within the Facets platform.
• Design, develop, and execute functional, integration, system, and regression s cases and s scenarios.
• Conduct backend validation using SQL, database queries, and healthcare claims data analysis.
• Analyze high-volume claims processing results and support quality assurance activities for large-scale healthcare transformation programs.
• Participate in defect triage sessions, perform root cause analysis, and validate defect fixes.
• Collaborate closely with business, configuration, development, and QA teams to ensure successful project delivery.

Requirements

• 10+ years of strong hands-on experience in Facets Claims Testing within healthcare payer environments.
• Deep understanding of healthcare payer claims adjudication processes and claims lifecycle management.
• Experience performing end-to-end front-end and backend validation of Facets Claims applications.
• Strong SQL skills with the ability to perform data validation, reconciliation, and backend sing.
• Experience sing Medicare Claims processing workflows and business rules.
• Proven experience supporting large-scale healthcare transformation, modernization, or Facets migration programs.
• Ability to work independently in a hands-on sing role while managing multiple priorities.

Qualifications

• Knowledge of healthcare EDI transactions, including 837 and 835 transaction sets.
• Experience working with federal healthcare programs, including CMS and Medicare initiatives.
• Exposure to s automation frameworks and automation sing practices.
• Experience with healthcare data migration and conversion sing.
• Prior experience working in large-scale payer transformation and Facets modernization programs.

Skills

• Knowledge of healthcare EDI transactions, including 837 and 835 transaction sets.
• Experience working with federal healthcare programs, including CMS and Medicare initiatives.
• Exposure to s automation frameworks and automation sing practices.
• Experience with healthcare data migration and conversion sing.
• Prior experience working in large-scale payer transformation and Facets modernization programs.

Benefits

• Medical/Dental/Vision/Life Insurance
• Paid holidays plus Paid Time Off
• 401(k) plan and contributions
• Long-term/Short-term Disability
• Paid Parental Leave
• Employee Stock Purchase Plan

Pay

The annual salary for this position is between $71,100 to $112,500 depending on experience and other qualifications of the successful candidate.

Schedule

This is a Remote position open to qualified applicants in the United States.