ACAS Plan Testing Analyst — Claims Validation & Design

CVS Health; Tennessee; Hybrid; USD 29,000 - 68,000; Full time

Job summary

CVS Health is seeking an Analyst, Plan Testing to support Commercial plan testing by interpreting client intent behind medical benefit designs and validating that intent through claims-based testing in ACAS. This role requires collaboration across teams and expertise in ACAS and PERS/CCI to ensure accurate testing before claim release.

The position emphasizes designing test strategies, guiding testers, and improving testing efficiency while aligning with plan adjudication knowledge and deadlines.

Qualifications

• 3+ years of ACAS experience and medical plan adjudication knowledge.
• Ability to manage multiple tasks and meet deadlines.
• Strong business and organizational knowledge.

Responsibilities

• Review client benefit intent and translate it into clear testing guidance for plan testers.
• Design test strategies, test plans, and test scenarios that validate the intended plan behavior.
• Provide instructions to testers on how to execute plan testing and confirm expected claims outcomes.
• Research testing issues when results do not align with expected outcomes and determine the appropriate next steps.
• Log confirmed defects with the appropriate contacts and support resolution through follow-up and clarification.
• Resolve questions and concerns raised by plan testers throughout the testing process.
• Continuously review automation opportunities and recommend improvements to strengthen testing efficiency and coverage.
• Analyze defect trends and adjust test strategies, scenarios, or claims selections as needed.

Skills

ACAS platform experience

Medical plan knowledge

Multi-tasking

Communication

Education

Associate's degree

Tools

ACAS

PERS/CCI

Job description

CVS Health is seeking an Analyst, Plan Testing to support Commercial plan testing by interpreting client intent behind medical benefit designs and validating that intent through claims-based testing in ACAS. This role requires collaboration across teams and expertise in ACAS and PERS/CCI to ensure accurate testing before claim release.

The position emphasizes designing test strategies, guiding testers, and improving testing efficiency while aligning with plan adjudication knowledge and deadlines.