Senior Manager – Medicare Testing

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🔥 45 minutes ago

🦌 Connecticut – Remote

🦌 Connecticut – Remote

💵 $82.9k - $182.5k / year

⏰ Full Time

🟠 Senior

👔 Manager

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Lead and oversee processes within the Quality Assurance organization • Develop and lead test strategies covering unit, user acceptance, end-to-end, regression, financial neutrality, and performance testing • Lead testing across claims platforms, including Medicare pricing and HealthEdge Source-related testing • Establish and monitor capabilities for effective test environments • Create comprehensive test scenarios with statistically valid volume for benefits, contracts, Medicare pricing, provider, configuration, and claim scenarios • Manage defect identification, resolution, and mitigation • Analyze Source-related pricing and claims behavior and validate expected versus actual outcomes • Recommend enhancements to metrics and reporting standardization • Integrate standards with quality principles and methodologies • Design, develop, and implement process improvements • Build relationships with technical and organizational leaders and partner with Medicare, Source, business, and technology stakeholders • Advise management on Medicare and Source testing risks, coverage, and quality considerations • Manage team performance through feedback, evaluations, engagement, motivation, and team development

🎯 Requirements

• 7+ years of experience in Quality Assurance • 5+ years of experience in design and execution of test strategy • Proven leadership experience setting strategic direction and influencing change with quantifiable positive outcomes • Knowledge of Medicare lines of business • Experience with HealthEdge Source or comparable healthcare claims pricing platforms • Ability to interpret pricing behavior, configurations, release changes, defects, and expected claim outcomes • Ability to travel up to 10% • Bachelor's degree required or equivalent experience

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • 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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