Healthedge/ Healthrules Configuration QA Consultant (with HealthRules Payor (HRP) experience)

100% Remote

6+ months

Key Responsibilities:

• Develop and execute test strategies and scripts using HealthRules Language (HRL).
• Validate benefit configurations, plan design, and logic within the HRP platform.
• Perform end-to-end testing of member benefits, including copays, coinsurance, accumulators, and claim adjudication logic.
• Work with BA and config teams to interpret benefit requirement documents (BRDs) and translate them into test cases.
• Identify configuration errors and work with cross-functional teams to resolve issues.
• Automate benefit validation and testing using HRL and available tools.
• Participate in test planning, defect triage, and release support activities.
• Prepare testing documentation including traceability matrices, test data sets, and test summary reports.

Required Skills:

• Proficiency in HRL (HealthRules Language).
• Strong experience with HealthRules Payor (HRP) platform.
• In-depth understanding of healthcare benefits, claims processing, and member enrollment.
• Experience in testing benefit plan logic and configuration.
• Ability to create and manage complex HRL scripts for validation purposes.
• Familiarity with HIPAA standards, especially 834/837 transactions (preferred).
• Experience with SQL for backend data validation.
• Knowledge of Agile methodologies and tools like JIRA, Confluence, etc.