QA-HRP / QNXT

Position : QA-HRP / QNXT

Location : Remote

Experience : 7-10 years

Duties :

Configure benefit plans, provider contracts, and pricing rules within the HealthRules system.

Develop Business Requirements Documents (BRDs) and test cases for testing new configurations.

Perform and document user acceptance testing (UAT) and other tests to validate configurations.

Collaborate with business analysts and technical teams to interpret requirements and resolve issues.

Ensure configurations are compatible with other internal systems and meet reporting requirements.

Review and analyze user stories, use cases, and requirements for the health rules payer system.

Develop and implement comprehensive test plans, strategies, and test cases for various levels (System, Integration, Regression).

Design and execute tests (manual or automated) specifically for the healthcare Payer and Claims domains, including business process assurance.

Identify, document, and report defects, bugs, and inconsistencies in the software using issue-tracking systems like Jira.

Work closely with developers, business analysts, and cross-functional teams to ensure alignment with project goals and to resolve issues.

Provide detailed test metrics and reports to stakeholders to ensure transparency and accountability in the testing process.

Contribute to the enhancement of testing processes and implement best practices to improve efficiency and outcomes.

Required :

Health Plan Domain Knowledge : Strong understanding of the health payer industry, including claims processing, benefits administration, provider contracts, and regulatory compliance.

HealthRules Platform Expertise : Proficiency with the HealthRules Payer system [QNext & HRP], including its configuration tools and the patented HealthRules Language.

Analytical Skills : The ability to analyze complex business requirements and translate them into system configurations.

Problem-Solving : Strong skills in identifying configuration errors, claims processing issues, and integration problems.

Technical Skills : Familiarity with SQL and data analysis tools, Knowledge of scripting language such as Python is a plus

Communication : Effective communication and collaboration skills to work with business stakeholders and technical teams.

Testing Methodologies - Proficiency in manual and / or automated testing methodologies.

Tools - Experience with tools like Jira for defect tracking and management.

Teamwork - Ability to work effectively as a team player and mentor junior team members.