QA Manager, Internal Claims Auditing

4062 Aetna Resources, LLC; United States; Remote; USD 54,000 - 159,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a QA Lead to manage the quality assurance team and guide testing strategy for complex software products. You will collaborate with cross-functional teams to define testing requirements, develop comprehensive test plans, and ensure timely, thorough testing across initiatives.

The role emphasizes data-driven insights using BI tools, strong problem solving, and a growth mindset to continually improve QA processes and outcomes.

Qualifications

• 5-7 years work experience in a claims or claims audit position.
• Strong execution, planning, and delivery skills.
• Experience with business intelligence.
• Strong problem solving and decision making.
• Collaborative and team-oriented mindset.
• Growth mindset with agility and development.

Responsibilities

• Lead QA team and set strategic objectives.
• Define testing requirements and test plans.
• Ensure timely, thorough testing of software products.
• Analyze testing metrics and report to stakeholders.
• Drive continuous QA improvement and deliver reliable software.

Skills

QA leadership

Test planning

Quality assurance

Cross-functional collaboration

Business intelligence

Problem solving

Growth mindset

Education

Post-secondary education

Tools

BI tools

Quality dashboards

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

Leads and manages the QA team by setting strategic objectives and ensuring the implementation of effective quality assurance processes. Collaborates with cross-functional teams to define testing requirements, develop test plans, and ensure timely and thorough testing of software products. Analyzes testing metrics, provides reports to stakeholders, and drives continuous improvement in QA practices to deliver high‑quality and reliable software solutions.

Required Qualifications

• 5-7 years work experience in a claims or claims audit position.
• Adept at execution and delivery (planning, delivering, and supporting) skills
• Adept at business intelligence
• Adept at problem solving and decision making skills
• Adept at collaboration and teamwork
• Adept at growth mindset (agility and developing yourself and others) skills

Preferred Qualifications

• 5+years of quality management, audit, compliance or operational quality experience
• Adept at growth mindset (agility and developing yourself and others) skills
• Demonstrated experience using quality metrics, KPIs, dashboards, and business intelligence tools to identify trends and present recommendations to senior leadership
• Experience leading root-cause analysis, corrective and preventive action (CAPA), risk mitigation, and continuous-improvement initiatives.Demonstrated ability to lead cross‑functional initiatives, manage competing priorities, develop employees, and communicate effectively with senior stakeholders.

Education

• Post secondary /high school education or specialized training, i.e., technical/vocational programs or equivalent work experience.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,300.00 - $159,120.00

This pay range represents the base hourly rate or base annual full‑time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short‑term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 10/30/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.