QA Lead

Role: QA Lead

Location: Remote

Key Responsibilities: 

• Lead end-to-end QA activities for RxCLAIM-based applications, including test strategy, planning, execution, and defect management

• Act as the QA point of contact for PBM/RxCLAIM initiatives, collaborating closely with business analysts, developers, and product owners

• Define and enforce QA processes, standards, and best practices across projects

• Review and validate business requirements, functional specifications, and technical designs from a QA perspective

• Design and oversee test scenarios, test cases, and test data covering eligibility, claims adjudication, pricing, formularies, benefits, accumulators, and prior authorization

• Lead and mentor QA analysts, providing guidance on RxCLAIM workflows and testing techniques

• Coordinate SIT, UAT, and regression testing, including support for business and client UAT cycles

• Ensure compliance with healthcare regulations and industry standards (HIPAA, CMS, etc.)

• Track test execution metrics, defect trends, and quality KPIs; report status to stakeholders

• Support automation initiatives by identifying regression candidates and working with automation teams

• Participate in release planning, production validation, and post-release defect analysis

Qualifications

• 8+ years of experience in QA/testing, with at least 3–4 years in a QA Lead role

• Strong hands-on experience with RxCLAIM (claims processing, plan setup, pricing, benefits, accumulators, DUR, PA)

• Solid understanding of PBM and pharmacy domain concepts

• Strong knowledge of test management and defect tracking tools (e.g., ALM, Jira, Zephyr, qTest)

• Excellent analytical, problem-solving, and communication skills

• Proven experience leading teams and coordinating with cross-functional stakeholders

Preferred Qualifications: 

• Experience with test automation tools and frameworks

• Exposure to other PBM platforms (e.g., QNXT, Facets, ICD)

• Experience working in Agile/Scrum environments

• ISTQB or similar QA certification