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

Summary

As an Test Lead (Manual Test, US Healthcare & Medicaid/Pharmacy) at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. This role is strictly involved in the development 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 development 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
• Do the math by helping prepare estimates for performing the various activities defined in the test plan 

What we're looking for

• 15+ years of overall experience with 5+ years specifically in Medicaid pharmacy operations, MMIS/MES systems, PBM functions, or pharmacy claims processing.
• Strong understanding of NDC, HCPCS, quantity limits, and drug pricing methodologies
• Strong understanding of Medicaid PDL, clinical PA criteria, DUR requirements
• Strong understanding of 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.

What you should expect in this role

Remote