Job Details:
Must Have Skills
QA Strategy & Transformation (Broadcom → IBM migration)
Data migration validation (reconciliation & regression)
Sampling-based validation for large datasets
Automation-led validation approaches
SQL / data validation techniques
Nice to have skills
Clinical Adjudication (CAM)
Medical necessity review processes
Authorization workflows
Clinical policy validation
Payer decision frameworks
Detailed Job Description
• Possesses strong experience in Clinical Adjudication (CAM), supporting medical necessity reviews, authorization workflows, and clinical policy validations, with solid alignment to payer decision frameworks.
• Demonstrates strong understanding of utilization management and coding guidelines, enabling effective collaboration with clinical and business stakeholders.
• Lead QA strategy for large-scale platform transformation (Broadcom → IBM stack), ensuring seamless transition across systems.
• Strong expertise in data migration validation, including before/after reconciliation and comprehensive regression coverage.
• Hands-on experience with sampling-based validation approaches for large enterprise datasets and systems.
• Proficient in automation-led validation, leveraging SQL/data checks and RPA/UI tools (e.g., UiPath) to drive efficiency.
• Ability to define QA operating model, team structure, and delivery roadmap (8–15 resources) aligned to program goals.
• Extensive exposure to enterprise-scale programs with multi-system dependencies (online, batch, and data migration ecosystems).
Minimum years of experience
8-10 years
Certifications Needed :No
Top 3 responsibilities you would expect the Subcon to shoulder and execute
Stakeholder Managment IT and Business
Test Managment and defect Management
Test Reporting and SLAs