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Quality Analyst - MedHOK

extra holidays - extra parental leave

Remote:

Full Remote

Contract:

Fixed term

Experience:

Senior (5-10 years)

Work from:

California (USA), United States

Offer summary

Qualifications:

Bachelor's degree in related field preferred, 5+ years of experience in MedHOK, Strong understanding of Medicaid and Medicare, Experience with healthcare regulations.

Key responsabilities:

Design and execute test plans
Collaborate with cross-functional teams

Impresiv Health SME https://www.impresivhealth.com/

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Job description

Title: Quality Analyst – MedHOK
Location: Remote, must work PST hours
Duration: 9-month contract (until October/November 2025)

Description:
We are seeking a highly skilled QA Specialist with specific experience in MedHOK to join our team. The ideal candidate will play a critical role in ensuring our software and processes meet required standards, function seamlessly, and deliver exceptional quality. This role involves designing and executing test plans, identifying and resolving defects, and collaborating with cross-functional teams to ensure MedHOK software solutions align with business and compliance requirements. A strong attention to detail, problem-solving ability, and expertise in MedHOK's functionality and workflows are essential.

What You Will Do:

Requirements Analysis
- Understand Business Needs: Review and understand the business requirements, especially those specific to Medicaid, Medicare, or DSNP.
- Traceability: Ensure all requirements are testable and properly mapped to QA processes.
Test Planning
- Develop Test Strategies: Create a comprehensive testing strategy, including functional, integration, regression, and user acceptance testing (UAT).
- Define Scope: Identify the modules or features in the MHK implementation that require testing.

Test Case Development
- Create Test Cases: Write detailed test cases that cover all possible scenarios, including edge cases, based on the requirements and design documents.
- Automation Scripts: If automation tools are used, develop automated test scripts for repetitive or complex test scenarios.
Test Execution
- Run Tests: Execute functional, integration, and regression test cases manually or via automation tools.
- Validate Data: Check data integrity in scenarios such as eligibility, authorization, claims, and member/provider data.
- System Integration Testing: Ensure MHK integrates seamlessly with other systems like EHR, claims processing, or reporting tools.

Defect Management
- Identify Issues: Log defects in tracking systems and provide detailed information for debugging.
- Retesting and Regression Testing: Validate defect fixes and ensure new changes don't affect existing functionality.
Compliance and Security Testing
- Regulatory Compliance: Test system configurations to meet CMS or other healthcare regulations.
- Data Privacy: Validate that the system adheres to HIPAA and other data security standards.

User Acceptance Testing (UAT) Support
- Collaborate with Users: Assist business users during UAT to verify the system meets real-world needs.
- Training Support: Provide feedback for user training materials based on testing insights.
Performance Testing
- System Load Testing: Assess how the MHK implementation handles peak loads and high transaction volumes.
- Response Time: Ensure acceptable performance levels for system operations and user interactions.

Documentation and Reporting
- Test Summary Reports: Provide comprehensive reports on test coverage, defect trends, and overall QA status.
- Maintain Documentation: Keep detailed records of test cases, defects, and results for audits or future reference.

You Will Be Successful If:

Strong analytical and problem-solving skills.
Excellent written and verbal communication.
Ability to manage multiple priorities in a fast-paced environment.
Team-oriented with a proactive and collaborative mindset.

What You Will Bring:

Bachelor's degree in Healthcare Administration, Information Systems, Business, or related field (preferred); or equivalent work experience instead of Bachelor's degree will be considered.
Advanced degree or certifications in healthcare management or IT (preferred).
5+ years of experience in MedHOK Care Performance Quality Assessment.
Previous experience ensuring MHK software and processes meet the required standards and functions as expected.
Strong understanding of Medicaid, Medicare, and DSNP operations and regulatory requirements.
Familiarity with CMS guidelines, Medicaid program standards, and DSNP requirements.
Proven track record of working with health plans or managed care organizations.
5+ years of consulting experience, preferably in healthcare or health IT.

About Impresiv Health:

Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.
Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do – provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it.

That's Impresiv!