Role OverviewWe 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 ResponsibilitiesDevelop detailed test cases, scenarios, and scripts for claims processing, enrollment, benefits, provider data, and EDI transaction flowsLead functional, integration, regression, and UAT cycles for assigned payer modulesAnalyze requirements and business rules — identify gaps, ambiguities, and testability issues before execution beginsOwn defect lifecycle management: logging, triage, root cause classification, retest, and closure trackingValidate EDI transactions (834, 837, 835, 270/271, 820) against payer business rules and X12 standardsSupport compliance and regulatory test cycles — ICD updates, CMS mandates, state-specific Medicaid rulesCoordinate with developers, BAs, and configuration teams to resolve blockers and clarify expected behaviorProduce daily/weekly execution status reports with defect metrics, coverage status, and risk flagsManages offshore QA analysts. Required Qualifications5+ years in software QA/testing2+ years in a lead or senior tester roleSolid experience testing U.S. healthcare payer systems — claims, enrollment, benefits, or provider networkWorking knowledge of EDI X12 transactions and HIPAA compliance requirementsHands-on test case design experience using boundary analysis, equivalence partitioning, and negative testing techniquesProficiency 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 SLAsStrong attention to detail — payer system defects have financial and compliance consequencesGeographic Responsibility: Remote, USType of Employment: Full-time, permanentFLSA Classification (USA Only): ExemptWork Environment: The physical demands described here are representative of those that
