QA Manager

QA Manager

Position Title: QA Manager

Responsibilities:- Lead and manage QA teams supporting PBM applications and claims processing platforms.- Establish, standardize, and continuously improve QA processes, methods, templates, and best practices.- Promote a quality-first culture through process discipline, automation, engineering rigor, and defect prevention.- Drive root cause analysis, corrective actions, and continuous improvement initiatives to improve product quality.- Provide subject matter expertise in PBM business processes, with a strong preference for Medicaid claims processing experience.- Validate end-to-end claims adjudication workflows, including eligibility, formulary, prior authorization, pricing, accumulators, coordination of benefits, reversals, rejects, and payment processing.- Partner with business, product, compliance, and technology stakeholders to ensure testing aligns with regulatory and business requirements.- Define, track, and report key quality metrics such as defect density, defect leakage, test coverage, automation coverage, test execution progress, cycle time, and release readiness indicators.- Use data-driven insights to identify risks, improve productivity, manage capacity, and optimize testing effectiveness.- Prepare and present quality dashboards, executive status updates, release readiness assessments, and risk summaries.- Participate actively in Agile ceremonies including sprint planning, backlog refinement, daily standups, retrospectives, and release planning.- Develop test strategies, test plans, test scenarios, and realistic test effort estimates for projects, releases, and production changes.- Coordinate testing across multiple initiatives while balancing scope, schedule, risk, and team capacity.- Collaborate closely with Product Owners, Developers, Business Analysts, Scrum Masters, Release Managers, and Operations teams.- Remain hands-on when needed across functional, integration, regression, system, UAT support, API, data validation, performance, and automation testing.- Evaluate and implement modern testing tools, frameworks, and accelerators that improve quality, speed, and repeatability.- Apply out-of-the-box thinking to solve complex quality challenges and remove delivery bottlenecks. Required

Qualifications:- 15+ years of software quality assurance experience, including hands-on test design and execution.- 5+ years of QA leadership or management experience.- Strong experience supporting PBM claims processing systems.- Deep understanding of SDLC, Agile execution, test estimation, risk-based testing, and release management.- Ability to define and manage quality metrics, dashboards, and team performance indicators.- Strong analytical, communication, stakeholder management, and problem-solving skills. Preferred

Qualifications:- Experience with Medicaid PBM programs is strongly preferred.- Experience with healthcare payer, pharmacy, managed care, or government healthcare systems.- Knowledge of healthcare compliance, regulatory requirements, audit readiness, and operational controls.- Experience with test automation frameworks, CI/CD pipelines, API testing tools, SQL, and data validation techniques.- Experience leading geographically distributed or vendor-partner QA teams. --- Position Title: PostgreSQL DBA

Responsibilities:- Install, configure, and maintain database server software, apply patches of PostgreSQL databases.- Create high availability cluster and a Disaster Solution plan.- Monitor database performance to identify slowdowns or potential issues.- Create database objects such as tables, views, triggers, and indexes.- Perform regular database backups to ensure data integrity in case of a server crash.- Perform regular scheduled maintenance on the database server, such as vacuum analysis on large tables to remove obsolete data. Required

Qualifications:- Bachelor’s degree in computer science, information technology, computer engineering or another related field.- Minimum 4 years of experience as a PostgreSQL DBA.- Experience in administering PostgreSQL databases.- Working experience using PostgreSQL ver. 16 and higher.- Experience with Database and SQL Tuning using PostgreSQL.- Assist development teams in optimizing PostgreSQL.- Proficient in SQL and advanced SQL.- Strong written and verbal communication skills.- Highly motivated, able to work both in a team and solo.- Must be able to meet deadlines and work well under pressure. Preferred

Qualifications:- Certification in PostgreSQL is preferred.- Experience with PGD is preferred.- Experience with MongoDB is preferred.- Experience with Microsoft Azure- Nice to have.- Experience with other databases like Oracle- Nice to have. --- Position Title: Test Engineer

Responsibilities:- Analyze NCPDP D.0 and F6 implementation requirements, payer sheets, field mapping documents, business rules, and transaction specifications to identify test scenarios and validation needs.- Create and maintain test plans, test scenarios, test cases, test scripts, test data, and traceability for pharmacy claim transaction testing.- Validate NCPDP pharmacy claim request and response transactions, including claim submission, reversal, eligibility, coordination of benefits, reject codes, messaging, pricing, accumulators, and coverage determination scenarios.- Perform functional, regression, integration, end-to-end, batch, database, API/interface, UAT support, Parallel and production validation testing for D.0 to F6 changes.- Develop and execute SQL queries to validate claims data, member eligibility, benefit setup, pricing, accumulators, drug data, payer configuration, and downstream reporting impacts.- Identify, document, track, retest, and close defects using approved defect management processes and tools.- Support test data creation for positive, negative scenarios.- Coordinate testing dependencies with PBM SMEs, business users, developers, PBM teams, and downstream application teams.- Prepare daily or weekly status updates, defect reports, test execution metrics, test coverage summaries, and implementation risk updates.- Participate in requirement reviews, design walkthroughs, payer sheet reviews, field mapping reviews, release readiness meetings, and implementation checkpoints. Required

Qualifications:- Minimum of 7 years of Quality Assurance or software testing experience, preferably in healthcare, PBM or pharmacy claims environments.- Hands-on experience testing pharmacy claims, claim adjudication, eligibility, benefits, pricing, accumulators, reject codes, and claim response messaging.- Working knowledge of NCPDP Telecommunication Standard