Sr QA Delivery Manager-Healthcare Interoperability

Job Summary:

We are seeking an experienced Senior Testing Manager to lead end-to-end Quality Engineering and Testing Services across Healthcare programs, including the strategic IOX (Interoperability and Operational Experience) platform. The role is responsible for driving testing strategy, delivery governance, quality assurance, automation transformation, healthcare interoperability validation, compliance testing, and stakeholder management across multiple healthcare portfolios.

The ideal candidate should possess strong expertise in both Manual and Automation Testing, deep healthcare domain knowledge, and a proven track record of successfully managing large-scale testing engagements, healthcare modernization programs, and distributed delivery teams.

Key Responsibilities:

• Own end-to-end testing delivery across IOX and Healthcare programs.
• Define and govern QA strategy, test processes, quality metrics, release readiness criteria, and quality gates.
• Lead Functional, Automation, API, Integration, SIT and UAT testing.
• Drive testing for healthcare interoperability initiatives including FHIR APIs, CMS compliance, and healthcare data exchange platforms.
• Oversee CMS-0057-F compliance validation, conformance testing, and FHIR-to-X12 mapping verification.
• Govern testing for healthcare business processes including Claims Processing, Eligibility & Enrollment, Provider Management, Prior Authorization, Care Management, Member Services and Payment Integrity.
• Establish automation strategy, roadmap, and adoption across healthcare programs.
• Manage multiple testing teams, vendors, and delivery partners across onsite-offshore delivery models.
• Monitor program health, quality KPIs, risks, dependencies, and mitigation plans.
• Conduct executive governance reviews and provide quality status reporting to leadership and clients.
• Drive continuous improvement, shift-left testing, DevOps enablement, and AI-assisted testing initiatives.
• Ensure compliance with HIPAA, healthcare regulations, data privacy, and security requirements.
• Govern production release validation, post-production quality monitoring, and defect leakage analysis.
• Support resource planning, budgeting, staffing, capability development, and succession planning.
• Act as the primary quality leadership representative during customer governance meetings, audits, and executive reviews.

Required Skills & Qualifications

Education

• Bachelor's degree in computer science, Information Technology, Engineering, or related field.
• Master's Degree (MBA/MS) preferred.

Experience

• 15+ years of experience in Software Testing and Quality Engineering.
• 5+ years of experience managing large-scale testing programs and QA delivery teams.
• Minimum 10+ years of healthcare domain experience.
• Proven experience managing onsite-offshore delivery models and executive stakeholder relationships.
• Experience leading enterprise healthcare transformation and modernization programs.
• Demonstrated experience leading Healthcare Interoperability programs involving FHIR APIs, CMS-0057-F compliance, Prior Authorization workflows, Patient Access APIs, Provider Access APIs, Payer-to-Payer Exchange, Healthcare Data Validation, and Conformance Testing.

Testing & Quality Engineering

• Strong expertise in Manual Testing and Test Automation delivery.
• Experience in Functional, Integration, System, End-to-End, UAT, Regression, and Accessibility Testing.
• Extensive knowledge of Test Planning, Estimation, Defect Management, Release Management, and Test Governance.
• Hands-on experience defining enterprise test strategies and quality governance models.
• Expertise in risk-based testing and quality assurance practices.

Automation & API Testing

• Experience with Selenium, Playwright, Tosca, Katalon, Functionize, or equivalent automation tools.
• Strong API testing experience using Postman, Rest Assured, Swagger/OpenAPI, and similar tools.
• Experience implementing automation frameworks and CI/CD-integrated testing solutions.
• Knowledge of API virtualization and service testing strategies.

Healthcare & Interoperability

• Strong understanding of Medicaid/MMIS/MES and Healthcare Payer systems.
• Experience with Medicaid Enterprise Systems (MES) modernization and healthcare digital transformation initiatives.
• Experience with Healthcare Claims Processing, Enrollment, Provider Management, and Prior Authorization workflows.
• Experience with HL7 FHIR standards and Healthcare APIs.
• Knowledge of CMS-0057-F compliance requirements.
• Experience with Inferno and conformance testing frameworks.
• Understanding of X12 transactions including 270/271, 278, 834, and Claims-related transactions.
• Experience with Patient Access APIs, Provider Access APIs, and Payer-to-Payer Exchange.
• Knowledge of HIPAA regulations and healthcare data privacy requirements.

Test Management & DevOps

• Experience with Azure DevOps, Jira, HP ALM/Quality Center.
• Exposure to Jenkins, GitHub, GitLab, and CI/CD pipelines.
• Familiarity with Agile, Scrum, SAFe, and DevOps delivery models.
• Experience in integrating automated testing within DevOps pipelines.

Leadership & Soft Skills

• Strong stakeholder management and executive communication skills.
• Experience managing multimillion-dollar testing portfolios, budgeting, forecasting, and resource planning.
• Proven ability to manage large QA organizations (50-200+ resources).
• Excellent problem-solving, risk management, and decision-making capabilities.
• Experience leading global delivery and customer-facing engagements.
• Strong mentoring, coaching, and people leadership skills.
• Ability to drive strategic quality transformation initiatives across multiple programs.

Preferred Certifications

• ISTQB Advanced Test Manager (CTAL-TM)
• ISTQB Test Automation Engineer (CTAL-TAE)
• Certified Manager of Software Testing (CMST)
• PMP (Project Management Professional)
• SAFe Agilist
• Certified Scrum Master (CSM)
• Certified Professional in Healthcare Quality (CPHQ)
• HL7 FHIR Certification
• CAHIMS (Certified associate in healthcare information and management systems)
• CPHIMS (Certified Professional in Healthcare Information and Management Systems)