23 days old

Medicare Business Acceptance Testing Lead Analyst- Work at Home-Cornerstone

Nashville, TN 37201
  • Job Code
Medicare Business Acceptance Testing Lead Analyst- Program Management Lead Analyst- Cornerstone

Location: Remote-Work at Home

As an enabler of Enterprise Strategic Priority for Medicare Advantage Growth, the Cornerstone program will drive a competitive administrative cost structure while delivering consistent, compliant operational performance. This will be accomplished through the implementation of a new operating model - transformation across people, process, and technology.

The Business Acceptance Testing (BAT and UAT) tester is responsible for developing and executing testing to ensure results align to expectations.

This individual will report to the BAT Lead. This individual will collaborate and communicate frequently with other BAT Testers or members of the technical and solution teams. This individual must possess an understanding of business processes and capabilities.

Primary Responsibilities

Assist in preparation and creation of test scenarios that match real life claims processing.

Participate in analysis of business processes to drive test workflows.

Create and execute the testing of business process scenarios for all aspects of Medicare business including provider matching, provider fallout, member validation, enrollment, disenrollment, MOOP/OOP, benefit terms, Rules and Rates, procedure codes, appeals.

Assist in preparation of compliance testcases reviewing compliance controls using samples from previous audit findings, CMS program audit, HIPPA guidelines, CMS reports etc. Ensure the business scenarios are executed on the system to support high quality and compliant solution.

Create configuration testcases for product and benefit setup, COB, CMS mandates, EGWP, Service and procedure codes, Accumulators etc.

Coordinate with Business SME and Business process optimization to understand various aspects of business needs

Work with Test data and Test environment teams on deployment schedule for BAT environment readiness for testing

Coordinate necessary access on tools/platforms to enable BAT testing

Gain a deep working knowledge of Medicare business, IT landscape, and coordinate collaboration across BAT team

Drive automation where possible for all BAT testing in collaboration with BAT Automation Engineers

Identify and document defects, issues, risks and dependencies

Develop and execute test scripts, test conditions, input test data, and expected results for Business Acceptance Testing/ User Acceptance Testing

Prepare Production checkout plan, data and scenarios working with business SME and end users

Coordinate with Product Owner, Technical Leads, Product Managers and QA on readiness for release and timeline

Measure and report test coverage across all applicable coverage dimensions

Ensure appropriate testing tasks are scheduled during release, iteration planning

Participate proactively in daily standup meetings, story grooming sessions, team retrospectives and suggest improvements

Establish standard processes for managing end user feedback, triaging issues and routing to and from product and engineering.

Provide recommendations for Go/ No Go release decisions

Minimum Qualifications

Bachelor's degree or equivalent experience required

Two or more years of related business or healthcare experience.

Candidate should have strong claim processing understanding, and advanced knowledge of health care coding, fee schedules and reimbursement methodologies

Knowledgeable with high complexity, high volume transaction healthcare claim environment

Experience in Quality Assurance and/or Business Acceptance Testing

Knowledge of data model/database design concepts and working knowledge of SQL

Experience in QNXT is preferred

Ability to work with shifting priorities to meet project requirements; self-motivated

Attention to detail, with strong analytical and problem-solving skills

Excellent written and oral communication skills

Experience working with multiple groups, both internally and externally - clients, engineering and product management teams

Ideal candidate will be resilient

Travel: less than 10%

This role is Work at Home which allows most work to be performed at home. Employees must be fully vaccinated if they choose to come onsite.

This position is not eligible to be performed in Colorado.

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

Posted: 2021-11-12 Expires: 2021-12-11
Sponsored by:
ADP Logo
Sponsored by:
Bank of America Logo

Featured Jobs[ View All ]

Featured Employers

Before you go...

Our free job seeker tools include alerts for new jobs, saving your favorites, optimized job matching, and more! Just enter your email below.

Share this job:

Medicare Business Acceptance Testing Lead Analyst- Work at Home-Cornerstone

Nashville, TN 37201

Join us to start saving your Favorite Jobs!

Sign In Create Account
Powered ByCareerCast