QA Test Manager

QA Test Manager **Job Title: QA Manager** **Employment Type:** Contract-to-Hire **Location:** Remote with Travel **Reports To:** Director Delivery **Domain:** PBM Claims Processing **Position Summary:** We are seeking an experienced and highly motivated QA Manager to lead quality engineering and testing initiatives for Pharmacy Benefit Management (PBM) platforms. The ideal candidate will bring a strong process orientation, an engineering mindset, hands-on testing depth, and proven experience managing QA teams using measurable quality and delivery metrics. **Key Responsibilities:** - **Quality Engineering Leadership** - 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. - **PBM Domain Expertise** - 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. - **Metrics-Based Team Management** - 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. - **Agile Delivery and Test Management** - 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. - **Hands-On Testing and Innovation** - 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. ** 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, 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.