Operations Advisor

The job profile for this position is Operations Advisor, which is a Band 4 Individual Contributor Career Track Role.

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Role Details
As an enabler of Enterprise Strategic Priority for Medicare Advantage Growth, the Dedicated Medicare Operating Model (DMOM) program will drive a competitive administrative cost structure while delivering consistent, compliant operational performance. This will be accomplished through the implementation of a new operating model – transformation across people, process, and technology.
The Operations Advisor is responsible for developing and executing testing to ensure results align to expectations. Responsibility will include the development of test automation, a new functionality to be leveraged within the program and post-program operations to ensure a high quality of system performance.

This individual will work with business, technology, and solution teams to develop and execute Service Readiness Validation (SRV) strategy for core business capabilities. This individual must possess strong understanding of business processes and capabilities, both functional and end-to-end, and prioritize testing of critical business processes and capabilities. This individual will be responsible for directing the work of User Acceptance Testers and providing coaching as needed.

PRIMARY RESPONSIBILITIES

• Coordinate with Business Operations leaders & IT Development teams to understand all aspects of business requirement

• Coordinate with QA/QE team on the capability test plans, scope for releases and provide frequent feedback, including recommendations for improvements, evaluation of problems and potential solutions

• Work with Test data and Test environment teams on all technical aspects of deployment for Service Readiness Validation (SRV) environment readiness for testing

• Provide leadership and guidance and coordinate necessary access for the team on tools/platforms to enable SRV testing

• Gain a deep working knowledge of Medicare business, IT landscape including environments, and coordinate collaboration of the SRV team

• Create SRV execution projections

• Drive automation first approach for all SRV testing in collaboration with SRV Automation Engineers

• Review and Contribute to the development and maintenance of a library of test cases that are designed to ensure that software, data, content and configurations meets business requirements.

• Lead SRV Defect triage meeting

• Develop and execute test scripts, test conditions, input test data, and expected results for Service Readiness Validation

• Prepare Production checkout plan, data and scenarios working with business SME and end users

• Identify and document defects, issues, risks and dependencies 

• Work with product owners to define acceptance criteria

• Coordinate with Product Owner, Technical Leads, Product Managers and QA on readiness for release and timeline

• Measure and report test coverage across all applicable coverage dimensions

• Ensure appropriate testing tasks are scheduled during release, iteration planning

• Actively collaborate with developers and business stakeholders to clarify requirements, especially in terms of testability, consistency, and completeness

• Participate proactively in daily standup meetings, story grooming sessions, team retrospectives and suggest improvements

• Coordinate production checkouts and engage end users and training team for production checkouts. 

• Deliver internal SRV results to ensure high quality before releasing a solution and collaborate with end user for exploratory SRV cycles

• Establish standard processes for managing end user feedback, triaging issues and routing to and from product and engineering.

• Provide recommendations for Go/ No Go release decisions based on sound SRV testing inclusive of functional and regression testing

MINIMUM QUALIFICATIONS

• Bachelor’s degree preferred or equivalent experience.

• Five+ Years of experience in Testing and Quality Engineering

• Two+ Year of experience of related business or healthcare experience.

• Candidate should have strong claim processing understanding, and advanced knowledge of health care coding, fee schedules and reimbursement methodologies.

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