Manager, IT Testing – Claims Domain

Conduent

. Serve as Claims Domain Test Manager for MMIS health care projects .

Posted 9/25/2026full-timeRemote • United StatesSeniorLead💰 $97,790 - $127,000 per yearWebsite

Tech Stack

Tools & technologies

SQL

About the role

Key responsibilities & impact

Serve as Claims Domain Test Manager for MMIS health care projects
Drive test strategy, testing processes, and claims-domain knowledge
Analyze business requirements and design and develop test plans
Ensure quality processes throughout the project lifecycle
Coordinate with customers on delivery and deployments
Provide testing guidance throughout the entire life cycle
Meet customer expectations and troubleshoot application problems
Assist customers with implementation decisions
Work closely with clients and development teams during development stages
Conduct milestone-completion demos and track and close demo feedback
Collaborate with development, architecture, and design teams to define GUI views and platform requirements
Validate the end-to-end flow from claim intake through payment and reporting
Test integration points between systems
Design test cases based on business rules, coverage policies, and system configurations
Validate backend data using SQL, including claim status, payment details, members, providers, and benefit plans
Validate EDI X12 files and test interfaces/APIs using tools such as Postman
Review requirements and documentation and create Requirements Traceability Matrices
Create test plans, test summary reports, and traceability matrices
Assess current product functionality against market trends and regulatory requirements for future product versions
Drive and communicate product-feature requirements with technical and architecture teams
Collaborate with cross-functional teams including developers, SMEs, and BAs

Requirements

What you’ll need

Strong health care domain experience, especially in the MMIS domain
Good knowledge of Medicaid and Medicare
Hands-on experience with claims processing and adjudication processes
Experience with reference codes/data sets required in claims adjudication
Experience or understanding of configuring benefits or programs in claims systems across various subsystems
Ability to run queries and perform basic system analysis and root-cause analysis (RCA)
Excellent written and spoken communication skills
Ability to multitask between internal teams and clients based on priority tasks
In-depth understanding of claims and claims lifecycle, including member, provider, paper and EDI X12 claim submission, adjudication, payment cycle, and reporting
Knowledge of professional, dental, institutional, pharmacy, encounter, and capitation claim types
Knowledge of EDI X12 formats including 837P/I/D, 835, 834, 270/271, and 276/277
Familiarity with claims systems such as CMdS, GHS, and Facets
Familiarity with test management tools such as ADO and JIRA
Familiarity with interface/API testing tools such as Postman
Minimum of 10+ years of health care experience, especially in the MMIS domain
SQL for backend data validation
EDI tools for validating X12 files
Understanding of data flows between systems and formats for interface testing
Ability to validate test scenarios, test plans, and test data
Ability to review requirements and documentation and create Requirements Traceability Matrices (RTM)
Ability to assess product functionality against market trends and regulatory requirements
Ability to drive and share requirements with technical and architecture teams
Experience creating test plans, test summary reports, and traceability matrices
Ability to collaborate with developers, SMEs, BAs, QA teams, clients, end users, and business units

Benefits

Comp & perks

Bonus or incentive eligibility based on business need
Health insurance coverage
Voluntary dental and vision programs
Life and disability insurance
Retirement savings plan
Paid holidays
Paid time off (PTO) or vacation and/or sick time
Reasonable accommodation for applicants with disabilities