Senior QA Tester – Healthcare Insurance / PBM (Pharmacy Benefit Management)

Senior QA Tester – Healthcare Insurance / PBM (Pharmacy Benefit Management)Location: Remote (USA)Employment Type: Full-TimeAbout Infinite Computer SolutionsInfinite is a global digital engineering and technology services company with over 20 years of experience helping Fortune 1000 organizations accelerate their digital transformation initiatives. We deliver innovative solutions across Healthcare, Telecommunications, Banking, and Financial Services, enabling our clients to modernize their technology ecosystems and achieve sustainable business growth.Job SummaryWe are seeking an experienced Senior QA Tester with a strong background in Healthcare Insurance, Medicaid/Medicare, or Pharmacy Benefit Management (PBM) environments. The ideal candidate will have expertise in healthcare claims processing, pharmacy benefit systems, and end-to-end testing methodologies, with the ability to support large-scale healthcare modernization initiatives.Key ResponsibilitiesPerform end-to-end testing across SIT, UAT, Regression, Parallel Testing, and Production Validation phases.Validate healthcare and pharmacy business processes including claims adjudication, prior authorization, formulary management, rebates, and pharmacy financial reconciliation.Develop and execute test strategies, test plans, test cases, and test execution schedules.Analyze business requirements and ensure testing aligns with CMS guidelines and Medicaid regulations.Perform backend data validation and analysis using SQL.Manage defects using ALM/JIRA and drive resolution with cross-functional teams.Collaborate with business stakeholders, developers, vendors, and SMEs to ensure successful project delivery.Prepare and maintain testing artifacts, including BRDs, FRDs, RTMs, process flows, and test reports.Monitor quality metrics, risks, issues, and provide regular status updates to leadership teams.Required Skills & Experience5+ years of experience in Healthcare IT, Health Insurance, Medicaid, Medicare, or PBM environments.Strong understanding of:Claims AdjudicationPrior AuthorizationPharmacy Benefit ManagementFormulary ManagementDrug Rebate ProcessingNCPDP TransactionsHands-on experience with SQL for data validation and analysis.Experience using ALM, JIRA, or similar test management tools.Familiarity with MMIS platforms, PBM systems, or healthcare portals.Strong documentation skills, including BRDs, FRDs, test cases, and process flows.Experience working in Agile/Scrum environments.Excellent communication and stakeholder management skills.