Test Lead (Manual Test, US Healthcare & Medicaid/Pharmacy)

Summary

As a ​Test Lead (Manual Test, US Healthcare & Medicaid/Pharmacy) at Gainwell, you will be a part of an innovative healthcare technology company with a mission to serve the healthcare needs of our communities. You will use your network testing and network management skills to drive the development of healthcare administration products used, and relied upon, by millions of patients. Most importantly, you’ll have the chance to grow and develop as a professional through our exceptional developmental opportunities. This role is strictly involved in the testing of the product and does not involve access to Protected Health Information (PHI) & Personally Identifiable Information (PII) or any secured/confidential client data. The work is limited to application testing and does not include handling or processing of sensitive health information.

Your role in our mission

Show that you’re a real pro as you support creating purpose-built solutions and technologies that help us deliver valuable better health and human services outcomes. 

• Perform vital testing, troubleshooting and analysis of application software for complex technical projects
• Design, develop, implement, maintain and monitor critical test processes 
• Gather requirements for testing, develop executable test cases and help distribute workload across a team of test engineers
• Coordinate and collaborate with others to analyze requirements to confirm, establish and communicate the defect-causing problem to the right stakeholders
• Assist, as needed, in writing proposals to recommend process and programs for clients based on system capability assessments performed
• Do the math by helping prepare estimates for performing the various activities defined in the test plan 

What we're looking for

• • 5+ years of experience in Medicaid pharmacy operations, MMIS/MES systems, PBM functions, or pharmacy claims processing.
  • Strong understanding of:
  • NDC, HCPCS, quantity limits, and drug pricing methodologies
  • Medicaid PDL, clinical PA criteria, DUR requirements
  • Pharmacy benefit administration and reimbursement models
  • Hands‑on experience with EDI transactions (837, 835, 278).
  • Experience with test management tools and SQL for data validation.
  • Familiarity with Gainwell, Conduent, Optum, Magellan, or other Medicaid pharmacy modules.
  • Overall 10+ Years of experience.

What you should expect in this role

• Remote work opportunity
• Shift Timing - 2 PM to 11 PM