Senior Manager, ACAS/Commercial Benefits Testing

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🕒 il y a 1 mois

🦌 Connecticut – Distant

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💵 $82 940 - $182 549 / an

⏰ Temps Plein

🟠 Senior

👔 Manager

👻 Score fantôme 28%

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🗣️🇺🇸🇬🇧 Anglais requis

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Logo of CVS Health

CVS Health

10 000+ employés

Fondée en 1963

🏥 Santé

⚕️ Assurance santé

🛒 Commerce de détail

Healthcare • Healthcare Insurance • Retail

CVS Health est une entreprise américaine de premier plan dans le domaine de la santé, dédiée à l'amélioration de l'accès et de l'accessibilité financière des soins de santé. L'entreprise s'appuie sur une approche globale qui comprend les services de santé, l'assurance santé et la gestion des prestations pharmaceutiques. À travers ses filiales, telles qu'Aetna et CVS Caremark, CVS Health propose une gamme de services qui favorisent le bien-être, la gestion des maladies chroniques et une couverture abordable des médicaments prescrits. CVS Health exploite des pharmacies de proximité, fournit des services de pharmacie par correspondance et gère des programmes de médicaments spécialisés, visant à rendre les soins de santé pratiques et accessibles à tous. Animée par une mission de connecter les individus aux services de soins essentiels, CVS Health s'engage à favoriser des communautés en meilleure santé et à soutenir le bien-être de toutes les personnes.

Description

• 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

🎯 Exigences

• 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

🏖️ Avantages

• 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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