Remote Pharmacy Testing Manager - PBM/Medicaid Lead

Gainwell Technologies LLC; Oregon; Hybrid; USD 87,000 - 124,000; Full time

Benefits offered by this job

Remote work

401(k) employer match

Educational assistance

Job summary

Gainwell Technologies is seeking a Pharmacy Testing Manager (PBM/Medicaid) to lead end-to-end pharmacy testing across SIT, UAT, and production validation, ensuring quality delivery of PBM and Medicaid pharmacy solutions.

This remote, US-based role offers minimal travel and a strong focus on testing leadership, with opportunities to grow within a company that values flexibility, learning, and career development.

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

Software testing

Test management

PBM experience

Medicaid experience

Claims adjudication

NCPDP transactions

Prior Authorization

Formulary management

Drug rebate processing

Pharmacy financial validation

Tools

ALM/JIRA

SQL

Job description

Gainwell Technologies is seeking a Pharmacy Testing Manager (PBM/Medicaid) to lead end-to-end pharmacy testing across SIT, UAT, and production validation, ensuring quality delivery of PBM and Medicaid pharmacy solutions.

This remote, US-based role offers minimal travel and a strong focus on testing leadership, with opportunities to grow within a company that values flexibility, learning, and career development.