Provider Test Lead (Tosca)

Role: Provider Test Lead

Location: Remote

Duration: Long-term/Fulltime

Job Summary
The Provider Test Lead is responsible for leading testing activities related to provider systems, integrations, and workflows within healthcare or insurance platforms. This role ensures high-quality delivery of provider data management, credentialing, contracting, directory, and claims-related solutions. The Provider Test Lead collaborates with business stakeholders, IT teams, vendors, and QA teams to ensure system integrity, regulatory compliance, and operational readiness.

Key Responsibilities Test Strategy & Planning

• Develop and execute comprehensive test strategies for provider-related applications.
• Define test scope, objectives, timelines, and resource requirements.
• Coordinate SIT, regression, end-to-end testing cycles, inSprint Automation using Tosca
• Ensure traceability between Epic, User Story, Test Cases and Defects in ADO and qTest

Provider Domain Testing

• Validate provider onboarding, credentialing, contracting, and directory management processes.
• Test provider data integrations (e.g., enrollment files, provider master data, NPI validation).
• Ensure accurate claims adjudication involving provider configurations.
• Validate compliance with regulatory requirements (CMS, state regulations, etc.).

Leadership & Coordination

• Lead QA analysts and offshore/onshore testing teams.
• Act as primary liaison between business SMEs, product owners, and technical teams.
• Coordinate defect triage meetings and drive issue resolution.
• Provide status reporting to stakeholders and leadership.

Automation & Tools

• Automate regression and insprint automation through Tosca
• Manage test management tools (e.g., Tosca, qTest and ADO).
• Ensure defect tracking and reporting accuracy.

Quality & Compliance

• Ensure adherence to QA standards and best practices.
• Support audits and compliance validation.
• Validate data integrity across systems.

Required Qualifications

• Bachelor s degree in Computer Science, Information Systems, Healthcare Administration, or related field.
• 7+ years of QA/testing experience.
• 3+ years of experience in healthcare provider domain testing.
• Strong knowledge of provider lifecycle (credentialing, contracting, directory, claims).
• Experience with healthcare systems (e.g., Facets, QNXT, HealthRules, etc.).
• Experience with EDI transactions (837, 835, 834).
• Strong SQL/data validation skills.
• Experience leading QA teams.

• ISTQB or relevant QA certification.

Key Competencies

• Strong analytical and problem-solving skills
• Excellent communication and stakeholder management
• Detail-oriented with strong documentation skills
• Ability to manage multiple priorities