IN4747-1
QA Testing Manager (PMP) with ACA, ICD-10, Medicaid, MMIS, MITS, HIPAA 5010, mainframes, EDI and healthcare/government experience
Location: Columbia/Seneca SC
Qty: 1
Duration: 12 Months
Affordable Care Act (ACA) is the nation’s health reform law to expand health coverage, increase benefits and modify the health care infrastructure. ACA contains numerous provisions with phased implementations.
ICD-10 represents a major improvement to medical coding practices (diagnosis and procedure codes) that impact both providers and payers requiring significant changes to related health care policies, business processes and information systems. ICD-10-CM will completely replace ICD-9-CM for dates of service on or after October 1, 2014; and ICD-10-PCS will replace ICD-9-CM for dates of discharge on or after October 1, 2014.
DAILY DUTIES / RESPONSIBILITIES:
Under general supervision, the Testing Manager evaluates Affordable Care Act (ACA) related legislation and assesses the impact. Collaborates with subject matter experts and business analysts to facilitate the adoption of ACA related initiatives. Help validate IT and business functional requirements; and identify and develop plans to support the implementations of ACA related initiatives. Assist in the development of new training, communication materials, implementation strategies and plans. Support the development and refinement of Contingency Plans and Operations Plans. Coordinate the testing of code, system, and configuration changes as a result of ACA related implementations, mandated by ACA, with Client, the Department of the State of South Carolina, and impacted agency functional areas and external partners, (i.e., hospitals, clearinghouses, managed care organizations, healthcare providers). The Test Manager will work collaboratively with the Client Program Manager, the Client Quality Assurance (QA) Manager, Client Development Team Manager, and the Department ACA/ICD10 Program Director. Support other ACA activities as required. The Test Manager will report to the Department ACA/ICD-10 Program Director.
REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
THE ABILITY TO:
1. Identify impacted agency functional areas and external partners with whom testing is required.
2. Determine what interaction with MCCS, if any, is required for ACA related testing and coordinate this interaction with MCCS, Client, Department, and any impacted agency functional areas, as well as external partners.
3. Work with Department ACA/ICD-10 Program Director to develop and distribute a general public notification of testing timelines to any impacted agency functional areas and external partners.
4. Create a schedule of timelines to include dates when each ACA related change will be ready for testing and dates when each impacted area (internal and external) is scheduled for testing.
5. Create a plan to assess overall readiness for ACA related testing. Include the identification of correct artifacts that impacted agency functional areas and external partners must have prior to testing.
6. In conjunction with the established test procedures used by Client QA and Department Medicaid, determine and document test procedures to be followed by the impacted agency functional areas and external partners. Communicate these test procedures to the impacted agency functional areas and external partners.
7. Work with Client QA and Department ACAICD-10 Program Director to develop a process for documenting defects identified when testing with impacted agency functional areas and external partners and the resolution of such defects.
8. Develop a re-test strategy with impacted agency functional areas and external partners
a) following the resolution of defects in the Medicaid MMIS System
b) following the resolution of defects in the found within the impacted agency functional areas and external partners.
9. Develop a detailed procedure to keep track of the status of testing with each identified impacted agency functional area and external partners.
10. Coordinate the execution of testing with Client QA, Client Development (as needed), Department, impacted agency functional areas and external partners, performing near real-time analysis of observed performance during and immediately after test execution. For defects or issues identified during testing that require more than immediate time to resolve, document these defects or issues and continue with testing as is appropriate.
11. Coordinate the verification of test results with Client QA, Department, and impacted agency functional areas and external partners.
12. Work with Client QA to develop a test plan for testing, utilizing any materials already used by Client QA and Department User Acceptance (UA) testing. Positive and negative testing scenarios should be used.
13. Work with Client Medicaid Information Technology Services (MITS) in Seneca, SC and Department ACA/ICD-10 Project Team in Columbia, SC. Job will require some travel between the two sites.
14. This position may require working more than 40 hours per week on an as-needed basis, including weekends. Hours worked over 40 hours per week must be approved in advance.
PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
- At least 8 years of experience working in a Payer environment (preferably Medicaid)
- Must have strong previous experience in the HIPAA transaction set
- At least 2 years of experience conducting and operating acceptance tests for a claims processing environment or major health plan (preferably Medicaid)
- Experience testing (preferably in a Mainframe environment) large complex (preferably Medicaid) Payer systems
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