Experienced Test Manager - PBM

Gainwell Technologies; Town of Texas, Northern (WI, KY); On-site; USD 91,000 - 130,000; Full time

Benefits offered by this job

Health benefits

401(k) match

Generous vacation policy

Job summary

Gainwell Technologies seeks an Experienced Test Manager - PBM to lead end-to-end testing for PBM and Medicaid pharmacy solutions, ensuring quality across SIT, UAT, and regression cycles.

The role demands 10+ years in software testing and 5+ years in test management, with strong PBM/Medicaid experience, NCPDP knowledge, and leadership capabilities. This is a fully remote position from Contiguous US locations, with competitive pay and benefits.

Qualifications

• 10+ years of software testing experience.
• 5+ years of Test Management.
• PBM/Medicaid pharmacy domain experience.
• Experience with NCPDP standards transitions (D.0, F2, or F6).
• Proficiency with ALM/JIRA and SQL for data validation.
• Strong leadership and stakeholder management skills.

Responsibilities

• Lead end-to-end pharmacy testing across SIT, UAT, Regression, and Parallel Testing for F6 transaction formats, ensuring quality delivery of PBM and Medicaid pharmacy solutions.
• Develop and manage test strategy, plans, schedules, and execution governance, ensuring alignment with compliance timelines and state Medicaid regulations.
• Validate and enforce NCPDP F6 transaction routing, data crosswalks, expanded product identifiers, and telephony compliance, including the D.0 to F6 transition across 271 Eligibility Response and Formulary and Benefit outbound extracts.
• Oversee pharmacy functional validation, including claims adjudication, drug pricing, formulary management, prior authorization, DUR, COB, rebates, and pharmacy financial reconciliation.
• Manage defects and cross-functional coordination among business SMEs, PBMs, switch networks, vendors, developers, conversion teams, and onshore/offshore testing resources to ensure timely issue resolution.
• Provide leadership reporting and sponsor-facing stakeholder communication by tracking quality metrics, risks, issues, and test progress.

Skills

Software testing

Test Management

NCPDP standards

SQL validation

Leadership

Stakeholder management

Tools

ALM/JIRA

SQL

Job description

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Experienced Test Manager - PBM

Date: Aug 26, 2026

Location: Any city, TX, US, 99999

Work Mode: Virtual (Exception only)

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

Summary

As aExperienced Test Manager - PBM (Pharmacy Benefit Manager) at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Your role in our mission

• Lead end-to-end pharmacy testing across SIT, UAT, Regression, and Parallel Testing for F6 transaction formats, ensuring quality delivery of PBM and Medicaid pharmacy solutions.
• Develop and manage test strategy, plans, schedules, and execution governance, ensuring alignment with compliance timelines and state Medicaid regulations.
• Validate and enforce NCPDP F6 transaction routing, data crosswalks, expanded product identifiers, and telephony compliance, including the D.0 to F6 transition across 271 Eligibility Response and Formulary and Benefit outbound extracts.
• Oversee pharmacy functional validation, including claims adjudication, drug pricing, formulary management, prior authorization, DUR, COB, rebates, and pharmacy financial reconciliation.
• Manage defects and cross-functional coordination among business SMEs, PBMs, switch networks, vendors, developers, conversion teams, and onshore/offshore testing resources to ensure timely issue resolution.
• Provide leadership reporting and sponsor-facing stakeholder communication by tracking quality metrics, risks, issues, and test progress.

What we're looking for

• 10+ years of software testing experience.
• 5+ years of Test Management experience.
• Strong PBM or Medicaid pharmacy experience, with direct exposure to NCPDP standards transitions (D.0, F2, or F6).
• Experience with large-scale DDI or MMIS modernization programs.
• Expertise in: Claims adjudication, NCPDP transactions, Prior Authorization, Formulary management, Drug Rebate processing, Eligibility (270/271) processing, Pharmacy financial validation.
• Experience using ALM/JIRA and SQL for data validation.
• Strong leadership, communication, and stakeholder management skills.

What you should expect in this role

• Fully remote options from Contiguous US locations only
• Video cameras must be used during all interviews, as well as during the initial week of orientation
• This posting is intended for pipelining. This is a developing position therefore the job description is subject to change.
• #LI-HC1

The pay range for this position is $90,900 - $129,900 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.