Remote Test Lead II — Healthcare Payer QA

HealthEdge; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

HealthEdge is seeking a Test Lead II with healthcare payer domain expertise to drive test planning and execution for payer system engagements. This hands-on role requires you to own test case design, defect management, and daily execution quality while coordinating with the Test Manager and cross-functional delivery teams.

You will develop detailed test cases for claims processing, enrollment, benefits, and EDI transactions, lead various test cycles, analyze requirements, and ensure compliance

Qualifications

• 5+ years in software QA/testing.
• 2+ years in a lead or senior tester role.
• Solid experience testing U.S. healthcare payer systems — claims, enrollment, benefits, or provider network.
• Working knowledge of EDI X12 transactions and HIPAA compliance requirements.
• Hands-on test case design experience using boundary analysis, equivalence partitioning, and negative testing techniques.
• Proficiency in defect tracking and test management tools (JIRA, Zephyr, ALM, or equivalent).
• Ability to read and interpret payer business rules, EOPs, benefit plan documents, and SLAs.
• Strong attention to detail — payer system defects have financial and compliance consequences.

Responsibilities

• Develop detailed test cases, scenarios, and scripts for claims processing, enrollment, benefits, provider data, and EDI transaction flows
• Lead functional, integration, regression, and UAT cycles for assigned payer modules
• Analyze requirements and business rules — identify gaps, ambiguities, and testability issues before execution begins
• Own defect lifecycle management: logging, triage, root cause classification, retest, and closure tracking
• Validate EDI transactions (834, 837, 835, 270/271, 820) against payer business rules and X12 standards
• Support compliance and regulatory test cycles — ICD updates, CMS mandates, state‑specific Medicaid rules
• Coordinate with developers, BAs, and configuration teams to resolve blockers and clarify expected behavior
• Produce daily/weekly execution status reports with defect metrics, coverage status, and risk flags
• Manages offshore QA analysts.

Skills

QA testing

Lead experience

HIPAA knowledge

Tools

JIRA

Zephyr

ALM

Job description

HealthEdge is seeking a Test Lead II with healthcare payer domain expertise to drive test planning and execution for payer system engagements. This hands-on role requires you to own test case design, defect management, and daily execution quality while coordinating with the Test Manager and cross-functional delivery teams.

You will develop detailed test cases for claims processing, enrollment, benefits, and EDI transactions, lead various test cycles, analyze requirements, and ensure compliance