Health Plan Testing Analyst — Validate Plans & Claims

CVS Health; Idaho; Hybrid; USD 2,893,000 - 6,761,000; Full time

Benefits offered by this job

Bonus eligibility

Comprehensive benefits package

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. The role emphasizes collaboration, strong communication, and expertise with ACAS and related platforms.

Responsibilities include designing test strategies and guiding testers, reviewing benefit intent, and ensuring accurate plan behavior before claim release.

Qualifications

• 3+ years of experience with the ACAS platform and knowledge of medical plan and claims adjudication.
• Ability to manage multiple tasks and meet deadlines.

Responsibilities

• Review client benefit intent and translate it into testing guidance for plan testers.
• Design test strategies, plans, and scenarios to validate intended plan behavior.
• Instruct testers on executing plan testing and confirming expected claim outcomes.
• Research testing issues and determine next steps when results diverge from expectations.
• Log defects and coordinate with contacts to resolve issues.
• Address questions from plan testers throughout the testing process.
• Identify automation opportunities and suggest improvements for testing efficiency.
• Analyze defect trends and adjust test strategies as needed.

Skills

ACAS platform experience

Claims adjudication knowledge

multitasking

Education

Associate's degree or equivalent experience

Tools

PERS/CCI tooling

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. The role emphasizes collaboration, strong communication, and expertise with ACAS and related platforms.

Responsibilities include designing test strategies and guiding testers, reviewing benefit intent, and ensuring accurate plan behavior before claim release.