Job Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Clinical QE, Role is responsible for creating and executing quality test cases to validate the clinical and functional integrity of web-based software application, work closely with software developers, business analysts and clinical coding experts to ensure the team delivers high quality product within the expected delivery window. Person should be capable of identifying the defects early during the software development lifecycle.
Clinical QE, He/She will be responsible for creating and executing clinical & functional test cases for a software product which works as a claim processor/claim scrubber/Clinical Rule engine.
Primary Responsibilities:

• Test case creation and execution

• Testing new features being developed to make sure the product is functionally & clinically viable

• Testing clinical rules/patterns being developed to ensure the rule correctly captures the essence of the sourced clinical/medical guidelines

• Ensure the product is compliant to the US Healthcare system

• Work closely with the Business Analysts, medical/clinical coding experts to clearly understand the business requirement of feature or rules and then co-ordinate with the software developers, other team members & stakeholders to ensure the feature being delivered is clinically and functionally accurate

• Create testing environments with special focus on replicating client's environment during defect research and fix

• Provide accurate and timely estimates for tasks
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

• Graduate degree or equivalent experience
• Clinical QE, understanding of US Healthcare system with medical coding experience to perform clinical and functional testing, medical coder
• Knowledge of Quality Engineering best practices
• Knowledge of the Agile methodology for delivering software solutions
• Working knowledge of Oracle & SQL DB. Should be an AI User leveraging AI tools like ChatGPT for generating content and answering queries
• Good understanding of US Healthcare system

• Proven good analytical skills and client like testing mindset

• Proven excellent verbal & written communication skills, problem solving and troubleshooting skills with focus on accuracy and attention to details

• Knowledge of AI User leveraging artificial intelligence tools to streamline business processes and boost productivity. This role involves using applications such as ChatGPT for generating content and answering queries

Preferred Qualification:

• Experience in tools such as Rally, intellij, GITHUB and or other testing tools

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.