Job description

• Minimum of 7 years of Quality Assurance or software testing experience, preferably in healthcare, PBM or pharmacy claims environments. • Hands-on experience testing pharmacy claims, claim adjudication, eligibility, benefits, pricing, accumulators, reject codes, and claim response messaging. • Working knowledge of NCPDP Telecommunication Standard Version D.0; exposure to Version F6 implementation or standards migration is strongly preferred. • Experience creating test plans, test cases, test scripts, test estimates, test data, and traceability matrices. • Strong understanding of SDLC methodologies, including Agile, Scrum, Waterfall, Iterative, or hybrid delivery models. • Solid SQL experience for backend validation, data reconciliation, and claims data analysis. • Experience with defect management, test execution tracking. QA reporting, and release validation. • Ability to interpret transaction layouts, payer sheets, field-level requirements, business rules, and technical mapping documents. • Strong analytical, troubleshooting, organizational, documentation, and problem- solving skills. • Effective written and verbal communication skills with the ability to explain testing results, defects, and implementation risks to technical and business audiences. • Ability to work independently and collaboratively in a fast-paced implementation environment.

Requirements

Must-haves

Minimum of 7 years of Quality Assurance or software testing experience, preferably in healthcare, PBM or pharmacy claims environments.
Hands-on experience testing pharmacy claims, claim adjudication, eligibility, benefits, pricing, accumulators, reject codes, and claim response messaging.
Experience creating test plans, test cases, test scripts, test estimates, test data, and traceability matrices.
Strong understanding of SDLC methodologies, including Agile, Scrum, Waterfall, Iterative, or hybrid delivery models.
Solid SQL experience for backend validation, data reconciliation, and claims data analysis.
Experience with defect management, test execution tracking. QA reporting, and release validation.
Ability to interpret transaction layouts, payer sheets, field-level requirements, business rules, and technical mapping documents.
Strong analytical, troubleshooting, organizational, documentation, and problem- solving skills.

Nice-to-haves

Working knowledge of NCPDP Telecommunication Standard Version D.0; exposure to Version F6 implementation or standards migration is strongly preferred.

Application prep

Use the role’s language and application details while tailoring your materials.

Keywords to mirror

agilescrumsql

Platform: jobdiva
Effort: medium