QA/Facets Analyst

SoftPathTechnologies; United States; Remote; USD 90,000 - 150,000; Full time

Job summary

SoftPathTechnologies is seeking a Senior QA Analyst with strong Medicaid payer and Facets expertise to independently validate state-specific regulatory implementations across Facets, Mainframe, Java, DataStage, Talend/TalendWorks and related applications.

This remote, full-time role requires experience across healthcare payer QA, TriZetto Facets, and ETL/SQL validation to ensure accurate enrollment, eligibility, benefits, claims adjudication, pricing and payments processing for multiple states.

Qualifications

• Strong healthcare payer QA/testing experience.
• Strong testing knowledge of TriZetto Facets.
• Testing experience across Mainframe and Java-based applications.
• Experience validating DataStage and Talend/TalendWorks processes.
• SQL and database testing skills.
• Strong Medicaid managed-care knowledge.
• Experience with state-specific Medicaid requirements.
• Good Medicare and Medicaid health-plan knowledge.
• Strong understanding of member enrollment, eligibility, benefits, claims, claims adjudication, pricing, payment.
• Experience performing quality assessments for complex regulatory implementations.

Responsibilities

• Analyze Medicaid regulatory requirements and develop comprehensive test scenarios for individual states.
• Validate end-to-end changes across Facets, Mainframe, Java applications, DataStage, Talend/TalendWorks, APIs/interfaces, batch systems and downstream apps.
• Test regulatory changes involving member enrollment, eligibility, benefits, claims adjudication, pricing, edits, and payments.
• Validate Mainframe and Java batch/interface processing.
• Perform ETL and source-to-target data validation.
• Conduct functional, integration, end-to-end, regression, negative, and boundary testing.
• Perform independent quality assessments of regulatory solutions.
• Identify gaps between regulatory requirements, requirements documentation, technical implementation, and actual system behavior.
• Perform SQL-based data validation and reconciliation.
• Conduct defect analysis and support root-cause investigation.
• Ensure traceability across Regulation Business Requirement System Change Test Scenario Test Result.

Skills

Healthcare QA/testing

Regulatory testing

Test planning

Regression testing

SQL testing

Tools

TriZetto Facets

Mainframe

Java

DataStage

Talend/TalendWorks

APIs/Interfaces

SQL databases

Job description

QA/Facets Analyst

Remote role

Fulltime position

Only GC or USC

Role Summary

Seeking a Senior QA Engineer with strong Medicaid payer and Facets expertise to independently validate state-specific regulatory implementations across Facets, Mainframe, Java, DataStage, Talend/TalendWorks, and associated applications.

Key Responsibilities

• Analyze Medicaid regulatory requirements and develop comprehensive test scenarios for individual states.
• Validate end-to-end changes across:
  • Facets
  • Mainframe
  • Java applications
  • DataStage
  • Talent/TalendWorks
  • APIs/interfaces
  • Batch systems
  • Upstream/downstream applications
• Test regulatory changes involving member enrollment, eligibility, benefits, claims adjudication, pricing, edits, and payments.
• Validate Mainframe and Java batch/interface processing.
• Perform ETL and source-to-target data validation.
• Conduct functional, integration, end-to-end, regression, negative, and boundary testing.
• Perform independent quality assessments of regulatory solutions.
• Identify gaps between regulatory requirements, requirements documentation, technical implementation, and actual system behavior.
• Perform SQL-based data validation and reconciliation.
• Conduct defect analysis and support root-cause investigation.
• Ensure traceability across Regulation Business Requirement System Change Test Scenario Test Result.

Required Experience

• Strong healthcare payer QA/testing experience.
• Strong testing knowledge of TriZetto Facets.
• Testing experience across Mainframe and Java-based applications.
• Experience validating DataStage and Talend/TalendWorks processes.
• SQL and database testing skills.
• Strong Medicaid managed-care knowledge.
• Experience with state-specific Medicaid requirements.
• Good Medicare and Medicaid health-plan knowledge.
• Strong understanding of:
  • Member enrollment
  • Eligibility
  • Benefits
  • Claims
  • Claims adjudication
  • Pricing
  • Payment
• Experience performing quality assessments for complex regulatory implementations.