Test Lead (Manual Test, US Healthcare & Medicaid/Pharmacy)

About the role

Gainwell is seeking a Test Lead to drive manual testing for US healthcare and Medicaid/pharmacy solutions. The role focuses on ensuring high‑quality application delivery without handling protected health information. You will work remotely with a team of test engineers to support critical health services.

Key responsibilities

• Perform testing, troubleshooting, and analysis of application software for complex technical projects.
• Design, develop, implement, maintain, and monitor critical test processes.
• Gather testing requirements, create executable test cases, and allocate work across the test team.
• Coordinate with stakeholders to analyze requirements and communicate defect causes.
• Assist in writing proposals to recommend process improvements.
• Prepare effort estimates for activities defined in the test plan.

Required profile

• 15+ years of overall experience with at least 5 years in Medicaid pharmacy operations, MMIS/MES systems, PBM functions, or pharmacy claims processing.
• Strong knowledge of NDC, HCPCS, quantity limits, drug pricing, Medicaid PDL, clinical PA criteria, and DUR requirements.
• Understanding of pharmacy benefit administration and reimbursement models.
• Hands‑on experience with EDI transactions (837, 835, 278).
• Familiarity with Gainwell, Conduent, Optum, Magellan, or similar Medicaid pharmacy modules.

Required skills

• SQL for data validation.
• Test management tools.
• EDI transaction processing (837, 835, 278).