Senior Manager, ACAS/Commercial Benefits Testing

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🕒 Agosto 10

🦌 Connecticut – Remoto

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💵 $82.940 - $182.549 / ano

⏰ Tempo Integral

🟠 Sênior

👔 Gerente

👻 Score fantasma 11%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of CVS Health

CVS Health

10.000+ funcionários

Fundada em 1963

🏥 Saúde

⚕️ Seguro de Saúde

🛒 Varejo

Healthcare • Healthcare Insurance • Retail

CVS Health é uma empresa líder de saúde nos Estados Unidos, dedicada a ampliar o acesso e a acessibilidade ao cuidado. A empresa adota uma abordagem abrangente que inclui serviços de saúde, seguro saúde e gestão de benefícios farmacêuticos (PBM). Por meio de suas subsidiárias, como Aetna e CVS Caremark, a CVS Health oferece uma variedade de serviços que promovem o bem-estar, a gestão de condições de saúde e a cobertura acessível de medicamentos prescritos. A CVS Health opera farmácias de bairro, oferece serviços de farmácia por correspondência e gerencia programas de medicamentos de especialidade, com o objetivo de tornar o cuidado com a saúde conveniente e acessível para todos. Movida pela missão de conectar pessoas a serviços essenciais de cuidado, a CVS Health está comprometida em fomentar comunidades mais saudáveis e apoiar o bem-estar de todas as pessoas.

Descrição

• Define and drive the quality engineering strategy for ACAS benefits testing, aligned with enterprise TCOE standards • Champion shift-left quality practices, including early validation of requirements, benefit configurations, and adjudication logic • Establish engineering-led approaches to defect prevention, testability, and quality gates • Lead adoption and expansion of automation-first testing for benefits and claims adjudication scenarios • Partner with automation architects and engineers to design scalable test frameworks, reusable assets, and data strategies • Define risk-based testing models focused on high-impact benefit configurations and claim scenarios • Guide teams in assessing claim exposure, financial risk, and member/client impact associated with defects • Analyze defect trends to identify systemic issues and inform upstream process or design improvements • Establish and monitor quality KPIs, including defect leakage, automation coverage, test effectiveness, and rework reduction • Drive continuous improvement initiatives to improve testing efficiency, consistency, and outcomes • Contribute to enterprise testing standards, best practices, and governance frameworks within the TCOE • Serve as a senior quality engineering partner to engineering, configuration, business, and audit teams • Influence design and configuration decisions through early quality and risk insights • Communicate quality risks, trends, and recommendations to senior stakeholders

🎯 Requisitos

• 7+ years of experience in healthcare technology or operations, with deep exposure to claims adjudication and benefits configuration • 5+ years in quality engineering, testing leadership, or QA management roles • Strong experience with claims adjudication systems and benefits testing, such as ACAS or similar platforms • Proven ability to design risk-based and scenario-driven testing strategies • Experience leading teams and influencing quality outcomes across cross-functional stakeholders • Strong analytical, problem-solving, and decision-making skills • Bachelor’s degree required or equivalent relevant work experience • Preferred: Experience in commercial health benefits and claims processing • Preferred: Familiarity with ACAS, PERS, or comparable adjudication platforms • Preferred: Strong executive-level communication skills and ability to translate complex quality risks into business impact

🏖️ Benefícios

• CVS Health bonus, commission or short-term incentive program • Award target in the company’s equity award program • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being

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