Plan Testing Analyst: Validate Medical Benefit Plans

CVS Health; Louisiana (MO); Hybrid; USD 60,460,000 - 140,634,000; 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. You will collaborate across teams to ensure accurate testing before claim release and guide testers through complex scenarios.

The role requires 3+ years with ACAS, knowledge of medical plan adjudication, and strong communication skills.

Qualifications

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

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

Claims adjudication

Project management

Communication

Education

Associate's 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 collaborate across teams to ensure accurate testing before claim release and guide testers through complex scenarios.

The role requires 3+ years with ACAS, knowledge of medical plan adjudication, and strong communication skills.