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Open nowFirst seen 6 days ago

SDET Engineer – Member Enrollment & Eligibility (Healthcare Domain)

Jobskey Consultancy662 open roles

Where
Bengaluru, Karnataka, India
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Your applicationOpen nowSDET Engineer – Member Enrollment & Eligibility (Healthcare Domain)Jobskey Consultancy · Bengaluru, Karnataka, India

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  6. 58.0%60 days
This job: first seen 6 days ago

The posting

Hiring Now: SDET Engineer – Member Enrollment & Eligibility (Healthcare Domain)

Locations: Bangalore | Chennai | Hyderabad | Pune | Vadodara Work Mode: Hybrid (2-3 Days Work from Office) Shift Timing: 2:00 PM – 11:00 PM IST Experience Required: 8+ Years Open Positions: 1 Notice Period: Immediate Joiners or Candidates Serving Notice Period (Must Join by 15th July)

Join a Leading Healthcare Transformation Program!

We are seeking a highly skilled SDET Engineer – Member Enrollment & Eligibility with deep expertise in Facets, Healthcare EDI Transactions, Enrollment Processing, Eligibility Validation, and Test Automation. This role is ideal for professionals experienced in managing complex enrollment ecosystems across Medicaid, Medicare Advantage, Duals, TRICARE, and Marketplace programs.

Key Skills Required

Facets (Mandatory) – Membership & Enrollment Modules X12 EDI Transactions (834, 820, 270/271) Enrollment Reconciliation & Validation SQL Data Validation & Analysis TOSCA Automation Testing Azure DevOps (ADO) Healthcare Payer Domain Expertise

Healthcare Domain Experience

Medicaid Medicare Advantage (MA) Duals / MMP Programs TRICARE Marketplace Plans

Core Functional Expertise

Enrollment & Membership Management

Member Enrollment Processing Subscriber Configuration Validation Member Add / Change / Term Scenarios Dependent Enrollment Validation Dual Enrollment Scenarios

X12 EDI Expertise

834 Benefit Enrollment & Maintenance Transactions 820 Premium Payment Validation 270 Eligibility Inquiry 271 Eligibility Response Validation

Eligibility & Reconciliation

Eligibility Cross-Validation Enrollment Reconciliation Across Systems Effective Date Validation Plan Code Verification Line of Business (LOB) Validation

Healthcare-Specific Processes

Retroactive Enrollment Adjustments Deeming Logic Validation Medicaid & Dual Eligibility Rules Premium Payment Linkage Validation

Key Responsibilities

Design and execute comprehensive enrollment and eligibility test scenarios, including:

  • New Enrollments
  • Member Changes
  • Terminations
  • Retroactive Adjustments
  • Dual Enrollment Cases

Validate end-to-end 834 enrollment transactions and Facets integration workflows

Lead 820 premium payment linkage validation and reconciliation testing

Perform 270/271 eligibility correlation testing across integrated healthcare systems

Conduct enrollment reconciliation between:

  • 834 Source Systems
  • Enrollment Databases
  • Claims Platforms
  • Eligibility Systems

Build and maintain automation frameworks using TOSCA or equivalent tools

Validate member-level data using SQL, including:

  • Effective Dates
  • Plan Codes
  • Coverage Periods
  • LOB Flags
  • Eligibility Indicators

Own offshore enrollment testing initiatives across multiple healthcare programs

Drive automation coverage, quality improvements, and mentor QA analysts

Conduct Root Cause Analysis (RCA) for:

  • Enrollment Discrepancies
  • Eligibility Issues
  • Reconciliation Failures
  • Premium Payment Linkage Errors

Preferred Qualifications

Strong Healthcare Payer Domain Experience Expertise in Enrollment & Eligibility Systems Experience with Medicare, Medicaid, and Marketplace Programs Knowledge of Regulatory Enrollment Compliance Requirements

Why Join?

Work on large-scale Healthcare Enrollment & Eligibility platforms Exposure to complex payer ecosystems and regulatory programs Opportunity to lead automation and quality engineering initiatives Collaborate with highly skilled healthcare technology teams Hybrid work model with excellent career growth opportunities

Interested candidates can share their updated resume at:

Email: [email protected] WhatsApp: +91 7013663419

#Hiring #SDET #HealthcareIT #HealthcareTesting #EnrollmentTesting #EligibilityTesting #Facets #EDI #X12 #834 #820 #270271 #TOSCA #SQL #AzureDevOps #Medicaid #MedicareAdvantage #Duals #MMP #TRICARE #Marketplace #AutomationTesting #QualityEngineering #HealthcareJobs #BangaloreJobs #HyderabadJobs #ChennaiJobs #PuneJobs #VadodaraJobs #Jobskey

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