Qa Engineer Facets Medicaid Regulatory Solutions

Job Title: Senior QA Engineer Facets & Medicaid Regulatory Solutions

Experience: Senior-level QA and testing experience
Employment Type: Recruit / Contract
Work Location: 100% Remote
Visa Eligibility: U.S. Citizens and Green Card holders

We are seeking a Senior QA Engineer with strong healthcare payer, TriZetto Facets, and Medicaid expertise to validate state-specific regulatory implementations across Facets, Mainframe, Java, DataStage, Talend/TalendWorks, and associated applications.

The ideal candidate will have experience with end-to-end cross-platform testing, regulatory compliance validation, SQL-based data verification, and complex healthcare claims and membership workflows.

• Analyze Medicaid regulatory requirements and develop comprehensive test scenarios for individual states.
• Validate end-to-end changes across Facets, Mainframe, Java applications, DataStage, Talend/TalendWorks, APIs, interfaces, batch systems, and upstream/downstream applications.
• Test regulatory changes involving member enrollment, eligibility, benefits, claims adjudication, pricing, regulatory edits, and payments.
• Validate Mainframe and Java batch processing and interface workflows.
• Perform ETL testing and source-to-target data validation.
• Conduct functional, integration, end-to-end, regression, negative, and boundary testing.
• Independently assess the quality and completeness of regulatory solutions.
• Identify gaps between regulatory requirements, business documentation, technical implementation, and actual system behavior.
• Perform SQL-based data validation, reconciliation, and database testing.
• Analyze defects and support root-cause investigations with development and architecture teams.
• Maintain end-to-end traceability from regulatory requirements through business requirements, system changes, test scenarios, and test results.
• Support defect triage, regression cycles, and implementation readiness assessments.

• Strong healthcare payer QA and testing experience.
• Strong testing knowledge of TriZetto Facets.
• Experience testing Mainframe and Java-based applications.
• Experience validating DataStage and Talend/TalendWorks processes.
• Strong SQL and database testing skills.
• Solid understanding of Medicaid managed-care operations and state-specific regulatory requirements.
• Good knowledge of Medicare and Medicaid health-plan processes.
• Understanding of member enrollment, eligibility, benefits, claims, claims adjudication, pricing, and payment processing.
• Experience validating complex regulatory implementations across multiple integrated systems.
• Strong analytical, documentation, defect management, and problem-solving skills.

• Experience with multiple state Medicaid programs.
• Medicare-Medicaid or dual-eligible program experience.
• Healthcare EDI/X12 knowledge.
• Experience with test automation, CI/CD, and quality engineering practices.
• Experience supporting large health plans or Medicaid Managed Care Organizations.

Fully remote position.

Candidates must demonstrate strong healthcare payer testing expertise, Facets knowledge, Medicaid regulatory experience, and the ability to validate end-to-end processing across multiple technical platforms.