Job details
Job type full-time
Full job description
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 performanceThis 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 leadThis individual will collaborate and communicate frequently with other bat testers or members of the technical and solution teamsThis 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 etcEnsure 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 homeEmployees 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 livesWe are a global health service company dedicated to improving the health, well-being and peace of mind of those we serveTogether, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millionsThrough our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovationWhen you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s livesWhat 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 supportDo not email seeyourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
