Operations Software Quality Analyst II - Facets Benefits Configuration Testing

CareSource; United States; Remote; USD 61,000 - 99,000; Full time

Job summary

A leading healthcare services company is seeking an Operations Software Quality Analyst II specializing in Facets Benefits Configuration testing. In this role, you'll perform detailed testing and validation, ensure data accuracy, and contribute to maintaining high-quality standards in the organization. You will collaborate closely with developers and QA teams to guarantee adherence to SLAs without defects in production, requiring hands-on experience in application quality assurance and benefits configuration.

Benefits

Comprehensive total rewards package

Performance-related bonuses

Inclusive work environment

Qualifications

• Minimum of five (5) years in application quality assurance required.
• Strong knowledge of configuration components like Base Mapping and BPA.
• Experience with TriZetto Facets database and core table queries.

Responsibilities

• Validate benefits configuration related to Cost Share, Limits, and Pre-Authorization.
• Test Workflow and PCA configurations for various programs.
• Execute CES testing to validate denials and clinical edits.

Skills

Benefits Configuration Testing

End-to-End Testing

Problem Solving

Education

Bachelor’s Degree or equivalent

Job description

Job Summary

We are seeking a highly skilled Operations Software Quality Analyst II to join our team, specializing in Facets Benefits Configuration testing.

In this role, you will collaborate with developers, QA team members, and managers to execute end-to-end testing processes.

Your contributions will ensure near-zero defect leakage into production and strict adherence to SLA timelines.

This position requires hands-on experience in benefits configuration testing, including CES and workflow. Please apply only if you meet this requirement.

Validate Facets Benefits Configuration
Perform detailed testing and validation of benefits configuration related to Cost Share, Limits, and Pre-Authorization:

• Strong working knowledge of configuration components including:
  • Base Mapping: TPCT, RCCT, SECT, TPPX
  • BPA: SPCR, SRCR
  • Supplemental: SPCT, SRCT
  • Other Components: SEDF, SEPY, IPMC, LTLT, LTSE

• Conduct Product/Shell configuration testing, including verification of Class/Plan IDs and Product IDs
• Leverage deep understanding of the TriZetto Facets database to perform core table queries and ensure data accuracy

Validate Facets Workflow and CES Configuration

• Test Workflow and PCA configurations for Medicaid, Medicare, and Duals programs
• Validate new and existing queue configurations, including override scenarios
• Execute CES testing to validate denials and clinical edits

Education and Experience:

• Bachelor’s Degree or equivalent years of relevant work experience is required
• Minimum of five (5) years of experience in application quality assurance required

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

$61,500.00 - $98,400.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds. #LI-GB1