Plan Testing & Validation Analyst

CVS Health

North Carolina

Hybrid

USD 29,000 - 68,000

Full time

12 days ago

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Bonus program

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 it through ACAS claims‑based testing. You will design test strategies and test plans, guide testers on execution, and collaborate with cross‑functional teams to ensure accurate plan behavior before claim release.

Opportunities to improve automation and coverage are encouraged.

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.