Plan Testing Analyst: Validate Health Plans & Claims

CVS Health; Nevada (IA); Hybrid; USD 29,000 - 68,000; Full time

Benefits offered by this job

Bonus program

Comprehensive benefits

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.

You will design test strategies and guidance for plan testers, coordinate validation of tests, and drive improvements in testing efficiency, with a focus on accuracy before claim release.

Qualifications

• 3+ years of experience with the ACAS platform and knowledge of medical plans and claims adjudication.
• Ability to manage multiple tasks and deliver within timelines.

Responsibilities

• Review client benefit intents and translate into testing guidance for plan testers.
• Design test strategies, plans and scenarios to validate plan behavior.
• Instruct testers on test execution and expected claim outcomes.
• Research defects and determine next steps.
• Log defects with contacts and support resolution.
• Address tester questions during testing process.
• Identify automation opportunities to improve testing efficiency.
• Adjust test strategies based on defect trends.

Skills

ACAS platform

Plan testing

Medical plan knowledge

Verbal communication

Written communication

Education

Associate degree

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.

You will design test strategies and guidance for plan testers, coordinate validation of tests, and drive improvements in testing efficiency, with a focus on accuracy before claim release.