100% Remote Medicaid QA Engineer (Eligibility, Medicaid, Claims) Contract Job Description: Role Summary Seeking a Senior QA Engineer with strong Medicaid payer and Facets expertise to independently validate state-specific regulatory implementations across Facets, Mainframe, Java, DataStage, Talend/TalendWorks, and associated applications.

Key Responsibilities

Analyze Medicaid regulatory requirements and develop comprehensive test scenarios for individual states. Validate end-to-end changes across: o Facets o Mainframe o Java applications o DataStage o Talend/TalendWorks o APIs/interfaces o Batch systems o Upstream/downstream applications Test regulatory changes involving member enrollment, eligibility, benefits, claims adjudication, pricing, edits, and payments. Validate Mainframe and Java batch/interface processing. Perform ETL and source-to-target data validation. Conduct functional, integration, end-to-end, regression, negative, and boundary testing. Perform independent quality assessments of regulatory solutions. Identify gaps between regulatory requirements, requirements documentation, technical implementation, and actual system behavior. Perform SQL-based data validation and reconciliation. Conduct defect analysis and support root-cause investigation. Ensure traceability across Regulation $B"(J Business Requirement $B"(J System Change $B"(J Test Scenario $B"(J Test Result. Required Experience Strong healthcare payer QA/testing experience. Strong testing knowledge of TriZetto Facets. Testing experience across Mainframe and Java-based applications. Experience validating DataStage and Talend/TalendWorks processes. SQL and database testing skills. Strong Medicaid managed-care knowledge. Experience with state-specific Medicaid requirements. Good Medicare and Medicaid health-plan knowledge. Strong understanding of: o Member enrollment o Eligibility o Benefits o Claims o Claims adjudication o Pricing o Payment Experience performing quality assessments for complex regulatory implementations.