QA Manager

Job Description Position TitleQA ManagerEmployment TypeCTHLocationRemoteReports ToDirector DeliveryDomainPBM Claims Processing PreferenceMedicaid PBM experience

Position Summary

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 requirements.

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.

Required 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 requirements, 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.