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:
- Current 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 (phone hidden)
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📌 SDET Engineer – Member Enrollment & Eligibility (Bengaluru)
🏢 Jobskey Consultancy
📍 Bengaluru