Test Lead (Manual Test, US Healthcare & Medicaid/Pharmacy)
Summary
As an Test Lead (Manual Test, US Healthcare & Medicaid/Pharmacy) at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. This role is strictly involved in the development of the product and does not involve access to Protected Health Information (PHI) & Personally Identifiable Information (PII) or any secured/confidential client data. The work is limited to application development and does not include handling or processing of sensitive health information. Your role in our mission We are seeking an accomplished Test Lead to lead and oversee quality assurance initiatives within our healthcare technology domain. This role requires a seasoned professional with deep expertise in Medicaid pharmacy operations and related systems, capable of driving testing excellence across complex projects and ensuring compliance with industry standards key Responsibilities Includes: Lead comprehensive test planning and execution for complex features and releases Define and implement robust testing strategies, including risk-based approaches Conduct advanced exploratory testing and edge-case validation Review requirements and designs to assess testability and identify quality risks Coordinate User Acceptance Testing (UAT) efforts with business stakeholders Provide mentorship and guidance to testing team Deliver clear reporting on testing progress, outcomes, and quality metrics What we're looking for Over all 15+ Years of experience. 5+ years of experience in Medicaid pharmacy operations, MMIS/MES systems, PBM functions, or pharmacy claims processing. Strong understanding of: NDC, HCPCS, quantity limits, and drug pricing methodologies Medicaid PDL, clinical PA criteria, DUR requirements Pharmacy benefit administration and reimbursement models Hands‑on experience with EDI transactions (837, 835, 278). Experience with test management tools and SQL for data validation. Familiarity with Gainwell, Conduent, Optum, Magellan, or other Medicaid pharmacy modules. What you should expect in this role Remote Environment Shift timimgs: 2PM to 11PM