Senior Manager Medicare Testing

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health’s unrivaled presence in local communities and their pharmacy benefits management capabilities, we’re joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.

Aetna is currently seeking a Senior Manager for the Test Center of Excellence team. This individual will be responsible for overseeing the design and implementation of the test strategy and process governance. Lead programs for test domains, associated applications, and functional testing support teams. Additionally, develop methodologies to achieve top-notch quality, cost efficiency, and timely deliverables.

You'll make an impact by:

• Leading and overseeing the processes within the organization’s Quality Assurance area, ensuring alignment with the overall business strategy.
• Developing and leading the test strategy for various components, including unit testing, user acceptance testing, end-to-end testing, regression testing, financial neutrality testing, and performance testing, across claims platforms, including Medicare pricing and HealthEdge Source-related testing.
• Establishing and monitoring the ongoing capabilities required for an effective test environment.
• Creating targeted and comprehensive test scenarios with statistically valid volume to ensure the expected performance of benefits and contracts, including Medicare pricing, provider, configuration, and claim scenarios.
• Managing the identification, resolution, and mitigation of defects, including analysis of Source-related pricing and claims behavior and validation of expected versus actual outcomes.
• Providing recommendations for enhancing metrics and reporting standardization.
• Integrating standards with quality principles and methodologies.
• Designing, developing, and implementing process improvement changes for the organization.
• Building relationships with technical and organizational leaders to ensure alignment and achievement of long-term testing objectives, partnering with Medicare, Source, business, and technology stakeholders as appropriate.
• Advising management on issues related to process implementation and refinement, including Medicare and Source testing risks, coverage, and quality considerations.
• Managing team performance through regular feedback, timely evaluations, and fostering engagement, motivation, and team development.
  

Required Qualifications

• 7+ years of experience in Quality Assurance
• 5+ years of experience in design and execution of test strategy, which includes components such as unit testing, user acceptance testing, end to end, regression testing, financial neutrality, performance testing, etc.  
• Multiple years proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes.
• Knowledge of Medicare lines of business
• Experience with HealthEdge Source or comparable healthcare claims pricing platforms, with the ability to interpret pricing behavior, configurations, release changes, defects, and expected claim outcomes.
• Ability to travel up to 10%

Preferred Qualifications

• Experience supporting HealthEdge Source release and regression testing, including analysis of pricing changes, historical defects, and production claim scenarios.
• Ability to translate Medicare and Source subject-matter expertise into test scenarios, expected outcomes, defect analysis, and reusable testing knowledge.

Education Requirements

• Bachelor's degree required or equivalent experience

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.  This position also includes an award target in the company’s equity award program. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.