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Healthrules Testing Jobs (NOW HIRING)

HealthEdge

Own product requirements for CMS integration certification and testing processes applicable to HealthRules Payer - including CMS Data Services Hub certification, Medicare EDI testing, FHIR API ...

HealthEdge

Product Manager, CMS Integrations

Own product requirements for CMS integration certification and testing processes applicable to HealthRules Payer - including CMS Data Services Hub certification, Medicare EDI testing, FHIR API ...

Pride Health

Senior System Analyst

Manhattan, NY · Hybrid

Support User Acceptance Testing (UAT), regression testing, and system validation activities ... Experience with HealthRules Payer (HRP) * Experience with GuidingCare * Experience supporting ...

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How much do healthrules testing jobs pay per hour?

As of Jun 7, 2026, the average hourly pay for healthrules testing in the United States is $43.50, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $52.40 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a HealthRules Tester, and why are they important?

To thrive as a HealthRules Tester, you need a strong understanding of software testing methodologies, health insurance business processes, and hands-on experience with HealthRules Payor or similar healthcare claims management platforms. Familiarity with test management tools, SQL for database validation, and relevant certifications such as ISTQB are commonly required. Attention to detail, effective communication, and analytical thinking are crucial soft skills for identifying issues and collaborating with technical and business stakeholders. These skills ensure accurate system validation, compliance with healthcare regulations, and smooth implementation of critical payer operations.

What are some common challenges faced when testing HealthRules software, and how can testers effectively address them?

Testing HealthRules software often involves navigating complex healthcare business rules, regulatory requirements, and data integration points. Testers may encounter challenges such as understanding intricate plan configurations, validating claims processing logic, and ensuring compliance with HIPAA or other standards. To address these challenges, it's important to collaborate closely with business analysts and developers, utilize comprehensive test cases that cover both positive and negative scenarios, and leverage automation tools where possible. Maintaining clear documentation and staying up-to-date with regulatory changes also helps ensure accurate and efficient testing.

What is the difference between Healthrules Testing vs Health Information Technician?

AspectHealthrules TestingHealth Information Technician
CertificationsTypically requires certifications in healthcare software testing or quality assuranceRequires certifications like Registered Health Information Technician (RHIT)
Work EnvironmentPrimarily in healthcare IT companies, software development, or testing labsHospitals, clinics, and healthcare facilities managing patient data
Job FocusTesting healthcare software for bugs, usability, and complianceManaging, coding, and maintaining patient health records
Industry UsageUsed in healthcare IT and software development sectorsCommon in healthcare providers and medical record departments

In summary, Healthrules Testing focuses on evaluating healthcare software for quality and functionality, often requiring IT and testing certifications. In contrast, Health Information Technicians manage and organize patient data, requiring specialized health information certifications. Both roles are vital in healthcare but serve different functions within the industry.

What is Healthrules testing?

Healthrules testing refers to the process of verifying and validating the functionality, performance, and compliance of HealthRules software, which is a core administration platform used by health insurance organizations. This testing ensures that all modules, such as claims processing, enrollment, and billing, work as intended and meet regulatory standards. The goal is to identify and resolve any defects or issues before the system is used in a live environment, thereby ensuring smooth operations and accurate data handling.
Infographic showing various Healthrules Testing job openings in the United States as of May 2026, with employment types broken down into 1% As Needed, 86% Full Time, 10% Part Time, and 3% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $90,490 per year, or $43.5 per hour.

HealthRules Configuration

Crea Services LLC

Sacramento, CA

Other

Posted 25 days ago

Job description

HealthRules Configuration

Sacramento, CA

Job description:

Primary Responsibilities

  • Lead HealthRules configuration activities for commercial group products, including:
    • Benefits configuration
    • Pricing and accumulator logic
    • Provider contracts
    • Claims processing rules
  • Triage, prioritize, and manage the configuration backlog, including:
    • Production defects
    • Enhancement requests
    • Annual readiness and renewal activities
  • Act as the primary intake point for configuration work from business owners and operations teams
  • Coordinate configuration handoffs and testing support with the offshore QA team
  • Provide technical guidance, oversight, and configuration code review for configuration analysts
  • Ensure configuration aligns with approved business requirements and testing standards
  • Deliver weekly status reporting to Client
  • Support operational stability
  • Operate in a ~20% supervisory / lead capacity, with the remainder in handson configuration and analysis

Required Skills & Experience

  • 7+ years of handson HealthRules Payer configuration experience
  • 3+ years supporting commercial group health plan configuration, including:
    • Deductibles
    • Outofpocket maximums
    • Accumulators
    • Tiered benefit designs
  • Expertlevel proficiency with:
    • HealthRules Designer
    • HealthRules Manager
    • HealthRules Language (HRL)
  • Demonstrated experience acting as a configuration lead or technical lead on HealthRules projects
  • Strong understanding of endtoend claims processing and benefits configuration
  • Strong communication skills with ability to:
    • Partner with business stakeholders
    • Explain technical configuration decisions clearly

Apply