**Role & Seniority: ** Test Lead / QA Lead (6–8 years), Healthcare domain; leads QA initiatives and teams

**Location & Work Type: ** Bangalore / Hyderabad; full-time (LPA not specified as work type)

**Stack/Tools: **

Test/Tracking: Jira or Azure DevOps; HP ALM/HP QC (preferred)
API/Services: Postman, SoapUI
DB: SQL
Automation: Selenium; also Playwright/Cypress (or equivalent)
Code/Repo: Git; CI/CD concepts
Process/Quality: Agile Scrum; Waterfall; SDLC/STLC; defect lifecycle management

**Top 3 Responsibilities: **

Test leadership: Define test strategy/plans, estimate effort, manage execution schedule, report quality metrics, track risks/defects
Functional & end-to-end testing: Validate PBM workflows (claims, eligibility, formulary, prior auth, rebates) across integrated healthcare systems
Domain validation & defect management: Validate pharmacy claims lifecycle including adjudication, DUR, NCPDP transactions, and support defect triage/root-cause

**Must-have Skills: **

Strong PBM/healthcare testing expertise (claims adjudication, eligibility verification, formulary, prior authorization, rebates)
Understanding of healthcare regulations/compliance (incl. HIPAA, Medicare Part D)
Building/maintaining test cases and scenarios; strong defect lifecycle and RCA skills
API testing (Postman/SoapUI), SQL proficiency
Automation experience with Selenium (or eq

Full Description

Job Description

Job Title

Test Lead - Pharmacy Benefit Management (PBM) Healthcare

Location

Bangalore / Hyderabad

Cost: 15 to 20 LPA

Job Summary

We are seeking an experienced Test Lead with 6 to 8 years of software testing experience, including strong expertise in the Pharmacy Benefit Management (PBM) healthcare domain. The ideal candidate will lead QA initiatives, define test strategies, manage testing teams, and ensure high-quality delivery of healthcare applications supporting pharmacy claims processing, formulary management, eligibility verification, prior authorization, rebates, and benefit administration.

The candidate should possess a deep understanding of PBM business processes, healthcare regulations, and software testing best practices across Agile environments.

Key Responsibilities

Test Leadership

Lead and mentor a team of QA analysts and test engineers. Define test strategy, test plans, and quality assurance processes. Estimate testing efforts and manage test execution schedules. Coordinate testing activities across development, business, and stakeholder teams. Track defects, risks, and quality metrics and provide regular status reports.

Functional Testing

Review business requirements, user stories, and functional specifications. Design and execute comprehensive test scenarios and test cases. Validate PBM workflows, claims adjudication, benefit plans, and pharmacy transactions. Perform end-to-end testing across integrated healthcare systems.

PBM Domain Validation

Test pharmacy claims lifecycle including

Claim adjudication
Eligibility verification
Drug utilization review (DUR)
Formulary management
Prior authorization
Specialty pharmacy workflows
Clinical programs
Medicare Part D processes
Rebate management
Validate NCPDP transaction standards and pharmacy data exchanges.
Defect Management

Log, prioritize, and track defects through closure. Perform root cause analysis and support defect triage meetings. Collaborate with development teams to resolve issues efficiently.

Automation & Process Improvement

Identify automation opportunities and improve test coverage. Review and support automation frameworks using Selenium, Playwright, Cypress, or equivalent tools. Drive continuous improvement initiatives for QA processes.

Compliance & Quality Assurance

Ensure compliance with healthcare regulations and data privacy requirements. Validate HIPAA-compliant workflows and data handling practices. Support audit and regulatory testing requirements.

Tools & Technologies

Jira / Azure DevOps HP ALM / QC (preferred) Postman / SOAP UI SQL Selenium or other automation tools Git CI/CD concepts

Methodologies

Agile Scrum Waterfall SDLC & STLC Defect Lifecycle Management

Keywords: PBM, Pharmacy Benefit Management, Healthcare Testing, Claims Adjudication, NCPDP, HIPAA, Medicare Part D, Prior Authorization, Formulary Management, QA Lead, Test Lead, Healthcare QA, API Testing, Automation Testing, Agile.

Qualifications

Range Of Year Experience-Min Year

Range Of Year Experience-Max Year