Test Lead, Manual Test, US Healthcare, Medicaid, Pharmacy
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Job Description
Test Lead (Manual Test) supporting application development for healthcare at Gainwell. Involves analysis, testing processes, and requirement gathering for Medicaid pharmacy operations.
Responsibilities:
- Perform vital testing, troubleshooting and analysis of application software for complex technical projects
- Design, develop, implement, maintain and monitor critical test processes
- Gather requirements for testing, develop executable test cases and help distribute workload across a team of test engineers
- Coordinate and collaborate with others to analyze requirements to confirm, establish and communicate the defect-causing problem to the right stakeholders
- Assist, as needed, in writing proposals to recommend process and programs
- Help prepare estimates for performing the various activities defined in the test plan
Requirements:
- 15+ years of overall experience
- 5+ years specifically in Medicaid pharmacy operations, MMIS/MES systems, PBM functions, or pharmacy claims processing
- Strong understanding of NDC, HCPCS, quantity limits, and drug pricing methodologies
- Strong understanding of Medicaid PDL, clinical PA criteria, DUR requirements
- Strong understanding of Pharmacy benefit administration and reimbursement models
- Hands‑on experience with EDI transactions (837, 835, 278)
- Experience with test management tools and SQL for data validation
- Familiarity with Gainwell, Conduent, Optum, Magellan, or other Medicaid pharmacy modules
Benefits:
- Flexible work arrangements
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