Remote Pharmacy Service Delivery Lead

Gainwell Technologies LLC; Clifton (TX); Remote; USD 87,000 - 124,000; Full time

Benefits offered by this job

Remote work

Educational assistance

Generous vacation policy

Job summary

Gainwell Technologies LLC is seeking an experienced Pharmacy Testing and Test Management professional to lead end-to-end testing for PBM and Medicaid pharmacy solutions. The role emphasizes collaboration with various stakeholders and adherence to CMS/state guidelines, in a fully remote U.S.-based setting.

You will develop test strategies, validate complex pharmacy processes, and drive defect resolution across SIT, UAT, and production environments, contributing to healthcare outcomes and

Qualifications

• 10+ years of software testing experience.
• 5+ years of Test Management experience.
• Strong PBM or Medicaid pharmacy experience.
• Experience with large-scale DDI or MMIS modernization programs.
• Expertise in: Claims adjudication, NCPDP transactions, Prior Authorization, Formulary management, Drug Rebate processing, Pharmacy financial validation.
• Experience using ALM/JIRA and SQL for data validation.

Responsibilities

• Lead end-to-end pharmacy testing across SIT, UAT, Regression, Parallel Testing, and Production Validation to ensure quality delivery of PBM and Medicaid pharmacy solutions.
• Develop and manage test strategy, plans, schedules, and execution governance, ensuring alignment with business requirements, CMS guidelines, and state Medicaid regulations.
• Oversee pharmacy functional validation, including claims adjudication, drug pricing, formulary management, prior authorization, rebates, NCPDP transactions, and financial reconciliation processes.
• Manage defects and cross-functional coordination among business SMEs, vendors, developers, conversion teams, and testing resources to ensure timely issue resolution and testing readiness.
• Provide leadership reporting and stakeholder communication by tracking quality metrics, risks, issues, and test progress.

Skills

Pharmacy testing

Test management

PBM/Medicaid

NCPDP transactions

Drug pricing/formulary

SQL validation

Tools

ALM/JIRA

SQL

Job description

Gainwell Technologies LLC is seeking an experienced Pharmacy Testing and Test Management professional to lead end-to-end testing for PBM and Medicaid pharmacy solutions. The role emphasizes collaboration with various stakeholders and adherence to CMS/state guidelines, in a fully remote U.S.-based setting.

You will develop test strategies, validate complex pharmacy processes, and drive defect resolution across SIT, UAT, and production environments, contributing to healthcare outcomes and