QA AI Lead

Responsibilities: Define and implement enterprise-wide AI testing and quality assurance strategies. Establish testing standards, governance, and best practices for AI/ML and Generative AI applications. Lead QA activities across AI product lifecycle from development through production deployment. Drive AI-powered quality engineering transformation initiatives. Validate LLMs, Chatbots, Copilots, and GenAI applications. Develop test scenarios for:- Prompt validation- Hallucination detection- Bias and fairness testing- Security and privacy testing- Performance and scalability testing- Explainability validation Define AI model quality metrics and monitoring standards. Design and implement automated testing frameworks. Integrate automated testing into CI/CD pipelines. Establish AI-assisted test generation and test optimization strategies. Drive shift-left and continuous testing practices. Lead and mentor QA Engineers, Automation Engineers, and AI Test Specialists. Collaborate with Product Owners, Architects, Developers, Data Scientists, and Business Analysts. Manage vendor and offshore QA teams. Conduct test planning, effort estimation, and release readiness reviews. Monitor quality KPIs and AI performance metrics. Present quality status and risk assessments to leadership teams. Ensure compliance with security, regulatory, and Responsible AI requirements.

Required Skills: Bachelor's degree in Computer Science, Information Technology, Engineering, or related field. Master's degree preferred. 10+ years of experience in Software Quality Assurance. 5+ years of Test Automation experience. 3+ years of experience testing AI/ML or Generative AI solutions. Experience leading QA teams and enterprise testing programs. ---

Responsibilities: Own requirements and functional design for assigned CMdS modules (Claims, Member, Finance, and related interfaces). Define epics, user stories, and definition of done; prioritize against Medicaid policy, MES certification goals, and release plans. Facilitate working sessions; clarify requirements for developers and QA; resolve functional questions during build and test. Track scope, dependencies, risks, and decisions; maintain traceability from legacy rule to CMdS design to test evidence. Lead functional design for claim intake, claim type assignment, validity/pricing edits, adjustment/void, crossover, encounters, remittance, and related edit disposition behavior; map legacy rules to CMdS configuration and customizations. Lead design for eligibility spans, aid category / benefit package assignment, enrollment, MCO/FFS indicators, and interfaces from state eligibility systems into CMdS Member. Lead design for payment cycles, budget account / category of service, fund splits, ASO / F/EA and other administrative payment paths, financial transactions, and reporting/accounting controls. Produce BRDs, FRDs, process flows, data mapping, gap analysis, and configuration workbooks suitable for build and UAT. Work side-by-side with developers on design walkthroughs, edge cases, and defect triage. Partner with QA to define test scenarios, expected results, and regression packs (positive/negative, adj/void, crossover, encounter, finance posting). Support SIT, UAT, and parallel/run-compare activities against legacy MMIS outcomes. Validate that implementations meet Medicaid policy and MES operational readiness (security, audit, reporting, interfaces). Run workshops with business owners, SMEs, fiscal, and operations. Align designs to CMS MES expectations (modularity, interoperability, standards-based interfaces, certification evidence). Support change management: training outlines, release notes, and operational runbooks for CMdS go-live.

Required Skills: 12+ years business analysis experience in Medicaid MMIS / MES, with deep hands-on work in at least two of: Claims, Member/Eligibility-Enrollment, Finance/Financial Accounting. Proven experience developing and implementing claims systems / MMIS / MES platforms. Experience modernizing or replacing legacy MMIS with a commercial Medicaid platform. Strong Medicaid domain knowledge. Demonstrated ability to write clear functional design and acceptance criteria for complex adjudication and financial rules. Experience working embedded with development and QA teams in Agile or hybrid SDLC. Excellent facilitation, documentation, and stakeholder communication skills. Bachelor’s degree in Business, Information Systems, Health Informatics, or related field (or equivalent experience).