Plan Testing Specialist: ACAS & Claims Validation Expert

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

Benefits offered by this job

Comprehensive benefits package

Bonus eligibility

Medical, dental and vision coverage

Job summary

CVS Health in New Jersey 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 with stakeholders and guide testers on how to validate plan behavior.

The role requires strong communication skills and expertise in ACAS, with a focus on accurate testing of new and revised plans before claim release.

Qualifications

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

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 with appropriate contacts and support resolution through follow-up.
• Resolve questions and concerns raised by plan testers throughout testing process.
• Continuously review automation opportunities and recommend improvements to strengthen testing efficiency and coverage.
• Analyze defect trends and adjust test strategies or claims selections as needed.

Skills

ACAS platform experience

Communication skills

Education

Associate's degree or equivalent experience

Job description

CVS Health in New Jersey 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 with stakeholders and guide testers on how to validate plan behavior.

The role requires strong communication skills and expertise in ACAS, with a focus on accurate testing of new and revised plans before claim release.