Health Plan Testing & Validation Analyst

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

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Wellness programs

Job summary

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

The position focuses on designing test strategies, guiding testers, logging defects, and researching issues while seeking automation improvements to increase

Qualifications

• 3+ years of experience with the ACAS platform and knowledge of medical plan adjudication.
• Ability to manage multiple tasks and deliver assignments within projected timelines.
• Excellent verbal and written communication skills.

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 next steps.
• Log confirmed defects and support resolution through follow-up and clarification.
• Resolve questions raised by plan testers during testing.
• Continuously review automation opportunities and improve testing efficiency and coverage.
• Analyze defect trends and adjust test strategies or claims selections as needed.

Skills

ACAS platform experience

Medical plan adjudication knowledge

Project/task management

Education

Associate's degree or equivalent experience

Tools

ACAS

PERS/CCI

Job description

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

The position focuses on designing test strategies, guiding testers, logging defects, and researching issues while seeking automation improvements to increase