Sr QA Analyst, Claims

Posted Yesterday
Hiring Remotely in USA
Remote
149K-165K Annually
Senior level
Healthtech • Insurance
The Role
Lead claims-focused QA automation, owning automation roadmap, building reusable components, enabling test data automation, mentoring engineers, defining testing strategy, ensuring in-sprint and regression automation, performing feasibility analysis, and reporting quality metrics to meet SLAs and prevent production defects.
Summary Generated by Built In
The Sr QA Analyst Claims assists QA team in ensuring overall quality assurance, and is responsible for driving in-sprint automation with Java, Selenium. The Sr QA Analyst Claims is responsible for bottom-line ownership for ensuring testing of all assigned initiatives are completed on time with quality outcomes. QA Lead supports and works with peers on integration, downstream testing to ensure no defects impact production processes. The Sr QA Analyst Claims is the subject-matter-expert (SME) in Claims, test automation, test data creation automation and enterprise test strategy definition, and embodies Healthfirst’s Culture Drivers promoting and reinforcing behavior consistent with Healthfirst culture. The role ensures all strategic and operational projects meet the highest quality by following industry recognized QA methodologies and best practices.

Duties & Responsibilities:

  • Owns the overall roadmap of automation solutions in collaboration with development and QA team.

  • Develops reusable automation components for Pega based and other applications

  • Mentors automation engineers in team to optimize automation outcomes

  • Develops utilities to enable test data automation

  • Performs feasibility analysis and identified potential test automation opportunities

  • Builds the testing process and policies along with defining technical solutions and tools to support the testing framework.

  • Emphasizes cross functional team collaboration, analytical prioritization and internal testing audits to ensure product quality.

  • Ensures automation for in-sprint and regression tests in claims program

  • Optimizes testing techniques to ensure the highest levels of quality standards are adhered to as per agreed upon Service Level Agreements (SLA's)

  • Reviews functional specifications and assists in evaluating test automation approaches.

  • Generates quality metrics in partnership with Release Management to provide accurate information on team performance.

  • Additional duties as assigned or necessary

Minimum Qualifications:

Applicants must have a Bachelor's degree in Computer Science, Computer Information Systems, Business Administration or related field and 7 years of experience in the job offered or in a quality assurance analyst occupation.

Position requires:

  • 6 years of experience performing in-sprint and regression test automation

  • 5 years of experience performing test data automation with other health plans

  • 6 years of experience in claims end-to-end lifecycle from a QA standpoint across claims pre-processing, adjudication and post-adjudication

  • 6 years of experience with Talend, Selenium, Jenkins, CT enablement

  • 5 years experience in claims system for claims process testing

  • 6 years of experience in Agile methodologies

  • 6 years of experience in structured testing methodology

  • 6 year of experience with Scorecards, Dashboards, Statement of Work (SOWs), SLAs Operational Level Agreement's (OLAs) and Performance management metrics

  • Professional, Academy for Health Care Management (PAHM) Certification

Any applicant who is interested in this position may apply online at http://careers.healthfirst.org or mail resume to HF Management Services, LLC, Attn.: Brandon Gottlieb.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER.  HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [email protected] or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services,  LLC.

Know Your Rights

All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst.  Healthfirst will never ask you for money during the recruitment or onboarding process.

Hiring Range*:

  • Greater New York City Area (NY, NJ, CT residents): $148,990 - $165,000

  • All Other Locations (within approved locations):

     $148,990 - $165,000

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

Skills Required

  • Bachelor's degree in Computer Science, Computer Information Systems, Business Administration or related field
  • 7 years of experience in the job offered or in a quality assurance analyst occupation
  • 6 years of experience performing in-sprint and regression test automation
  • 5 years of experience performing test data automation with other health plans
  • 6 years of experience in claims end-to-end lifecycle from a QA standpoint across claims pre-processing, adjudication and post-adjudication
  • 6 years of experience with Talend, Selenium, Jenkins, CT enablement
  • 5 years experience in claims system for claims process testing
  • 6 years of experience in Agile methodologies
  • 6 years of experience in structured testing methodology
  • 6 year of experience with Scorecards, Dashboards, Statement of Work (SOWs), SLAs, OLAs and performance management metrics
  • Professional, Academy for Health Care Management (PAHM) Certification

Healthfirst, Inc Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Healthfirst, Inc and has not been reviewed or approved by Healthfirst, Inc.

  • Healthcare Strength Healthcare coverage is positioned as a comprehensive offering, including medical/dental/vision options and additional mental-health support through Spring Health. Wellness credits and disability coverage further strengthen the perceived breadth of health-related support.
  • Leave & Time Off Breadth Time off appears robust, with paid time off plus a set of paid holidays and additional early office-closure days. A designated Social Justice day and noted parental/bereavement leave options add to the overall leave breadth.
  • Retirement Support Retirement support is framed around a 401(k) program with a company match that can reach a meaningful level after a tenure milestone. This match is repeatedly highlighted as a notable component of total rewards value.

Healthfirst, Inc Insights

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The Company
HQ: New York, NY
3,909 Employees
Year Founded: 1993

What We Do

Healthfirst is a provider-sponsored health insurance company that serves 1.8 million members in downstate New York. Healthfirst offers top-quality Medicaid, Medicare Advantage, Child Health Plus, and Managed Long Term Care plans. Healthfirst Leaf Qualified Health Plans and the Healthfirst Essential Plan are offered on NY State of Health, The Official Health Plan Marketplace. Healthfirst offers Healthfirst Pro and Pro Plus, Exclusive Provider Organization (EPO) plans for small-business owners and their employees, and Healthfirst Total, an EPO for individuals. For more information on Healthfirst, visit www.healthfirst.org

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