[Remote] QA/Test Engineer with strong pharmacy claims and PBM

Note The job is a remote job and is open to candidates in USA. VBeyond Corporation is seeking an experienced QA/Test Engineer to support a pharmacy claims and PBM implementation migrating from NCPDP D.0 to F6. The role focuses on validating transaction changes, claim adjudication, eligibility, coordination of benefits, data mapping, regression coverage, and production readiness while collaborating with technical and business stakeholders. Responsibilities Analyze NCPDP D.0 and F6 implementation requirements, payer sheets, field mapping documents, business rules, and transaction specifications to identify test scenarios and validation needs Create and maintain test plans, test scenarios, test cases, test scripts, test data, test estimates, and traceability matrices for pharmacy claims transaction testing Analyze requirements and coordinate with Business Analysts, PBM Subject Matter Experts, development teams, and business stakeholders Validate NCPDP pharmacy claim request and response transactions, including Claim submission and reversal Eligibility Coordination of Benefits (COB) Reject codes and response messaging Pricing Accumulators Coverage determination Perform functional, regression, integration, end-to-end, batch, API/interface, UAT, parallel, and production validation testing for D.0 to F6 changes Develop and execute SQL queries to validate claims data, member eligibility, benefit setup, pricing, accumulators, drug data, payer configuration, and downstream reporting impacts Perform defect management, test execution tracking, QA reporting, and release validation Interpret transaction layouts, payer sheets, field-level requirements, business rules, and technical mapping documents Prepare daily or weekly status updates, defect reports, test execution metrics, test coverage summaries, and implementation risk updates Participate in requirements reviews, design walkthroughs, payer sheet reviews, field mapping reviews, release readiness meetings, and implementation checkpoints Support post-implementation validation and defect triage Collaborate with technical and business stakeholders to troubleshoot issues and ensure successful production implementation Skills 7+ years of Quality Assurance or software testing experience, preferably in healthcare, PBM, or pharmacy claims environments Hands-on experience testing pharmacy claims, claim adjudication, eligibility, benefits, pricing, accumulators, reject codes, and claim response messaging Working knowledge of NCPDP Telecommunication Standard Version D.0 Exposure to NCPDP F6 implementation or standards migration is strongly preferred Experience creating test plans, test cases, test scripts, test data, test estimates, and traceability matrices Strong understanding of SDLC methodologies, including Agile, Scrum, Waterfall, iterative, or hybrid delivery models Solid SQL experience for backend validation, data reconciliation, and claims data analysis Experience with defect management, test execution tracking, QA reporting, and release validation Ability to interpret transaction layouts, payer sheets, field-level requirements, business rules, and technical mapping documents Strong analytical, troubleshooting, organizational, documentation, and problem-solving skills Excellent written and verbal communication skills, with the ability to explain testing results, defects, and implementation risks to both technical and business audiences Ability to work independently and collaboratively in a fast-paced implementation environment Bachelor's degree preferred; equivalent industry experience may be considered Benefits Remote work Company Overview VBeyond Corporation is a staffing and recruiting company specializing in emerging search and HR consulting services. It was founded in 2006, and is headquartered in Hillsborough, New Jersey, USA, with a workforce of 201-500 employees. Its website is http//vbeyond.com.