Macess Jobs (NOW HIRING)

We can only consider US Citizens or Green Card holders for this position at this time.

Overview

We are looking for a Test Manager with deep expertise in U.S. healthcare payer systems to lead end-to-end testing delivery across multiple client engagements. This role owns test strategy, governance, and quality outcomes for implementations, migrations, and regulatory releases on payer platforms.

Key Responsibilities

• Define and own test strategy, test plans, and entry/exit criteria across all assigned payer client engagements
• Lead test execution for claims adjudication, enrollment, benefits configuration, EDI transactions (834, 837, 835, 270/271), and provider network modules
• Establish and enforce QA governance standards - defect triage cadence, test coverage metrics, sign-off protocols, and release readiness criteria
• Drive compliance readiness for CMS regulatory releases, ACA mandates, and HIPAA requirements
• Manage and mentor offshore team of test leads and QA analysts;
• Serve as primary QA point of contact for client stakeholders - deliver status reporting, risk assessments, and go/no-go recommendations
• Identify production defect leakage patterns and implement upstream test improvements to close coverage gaps
• Partner with business analysts, developers, and configuration teams to ensure testability of requirements
• Ensure all regulatory and compliance test cases are reviewed and signed off before any production release

Required Qualifications10+ years in software QA/testing3+ years in a test management role5+ years testing U.S. healthcare payer platforms (e.g., TriZetto QNXT/Facets, NICE/IntelliSource, Macess, Salesforce Health Cloud)Strong domain knowledge: claims lifecycle, COB, prior auth, enrollment/disenrollment, benefit plan configuration, EDI X12 transactionsStrong stakeholder communication - ability to translate test findings into risk language for non-QA audiencesExperience managing an offshore team

Preferred ExperienceDemonstrated experience with CMS regulatory compliance testing -  ACA, ICD updates, or Medicare/Medicaid programsProficiency in test management tools (JIRA, Zephyr, ALM, Azure DevOps, or equivalent)Experience building or overseeing functional and regression test suites; familiarity with automation approaches in payer environments

Geographic Responsibility:  Remote, US

Type of Employment: Full-time, permanent 

FLSA Classification (USA Only): Exempt 

Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job: 

• The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.  

• Work across multiple time zones in a hybrid or remote work environment. 

• Long periods of time sitting and/or standing in front of a computer using video technology. 

• May require travel dependent on company needs. 

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990.  Candidates may be required to go through a pre-employment criminal background check. 

HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities. 

#LI-Remote 

**The annual US base salary range for this position is $120,000 to $140,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will bedeterminedduring the interview process and is based on a combination of factors including, but not limited to,your skills, experience,qualificationsand education.