Senior Manager ACAS/Commercial Benefits Testing

Position Summary

At CVS Health, we are building a world of health around every consumer through innovation, accountability, and quality. As part of this mission, the Testing Center of Excellence (TCOE) plays a critical role in ensuring that our platforms deliver accurate, compliant, and reliable outcomes for members and clients.

The Senior Manager, Quality Engineering is a strategic leadership role responsible for embedding quality engineering practices across the ACAS (Aetna Claim Adjudication System) benefits ecosystem. This role goes beyond test execution to drive defect prevention, shift‑left quality, automation, and risk‑based testing across the delivery lifecycle.

The Sr. Manager, Quality Engineering leads teams that design scalable testing approaches, strengthen upstream quality, and reduce downstream claims rework and financial risk. The role partners closely with engineering, configuration, product, and operations leaders to ensure quality is engineered into solutions—not inspected at the end.

Key Responsibilities

Quality Engineering Strategy & Leadership

• Define and drive the quality engineering strategy for ACAS benefits testing, aligned with enterprise TCOE standards.
• Champion shift‑left quality practices, including early validation of requirements, benefit configurations, and adjudication logic.
• Establish engineering‑led approaches to defect prevention, testability, and quality gates.

Automation & Modern Testing Enablement

• Lead the adoption and expansion of automation‑first testing for benefits and claims adjudication scenarios.
• Partner with automation architects and engineers to design scalable test frameworks, reusable assets, and data strategies.

Risk‑Based Testing & Defect Prevention

• Define risk‑based testing models focused on high‑impact benefit configurations and claim scenarios.
• Guide teams in assessing claim exposure, financial risk, and member/client impact associated with defects.
• Analyze defect trends to identify systemic issues and inform upstream process or design improvements.

Governance, Metrics & Continuous Improvement

• Establish and monitor quality KPIs (defect leakage, automation coverage, test effectiveness, rework reduction).
• Drive continuous improvement initiatives to improve testing efficiency, consistency, and outcomes.
• Contribute to enterprise testing standards, best practices, and governance frameworks within the TCOE.

Collaboration & Stakeholder Partnership

• Serve as a senior quality engineering partner to engineering, configuration, business, and audit teams.
• Influence design and configuration decisions by providing early quality and risk insights.
• Communicate quality risks, trends, and recommendations clearly to senior stakeholders.

Required Qualifications

• 7 + years of experience in healthcare technology or operations, with deep exposure to claims adjudication and benefits configuration.
• 5 + years in quality engineering, testing leadership, or QA management roles.
• Strong experience with claims adjudication systems and benefits testing (e.g., ACAS or similar platforms).
• Proven ability to design risk‑based and scenario‑driven testing strategies.
• Experience leading teams and influencing quality outcomes across cross‑functional stakeholders.
• Strong analytical, problem‑solving, and decision‑making skills.

Preferred Qualifications

• Experience in commercial health benefits and claims processing.
• Familiarity with ACAS, PERS, or comparable adjudication platforms.
• Strong executive‑level communication skills with the ability to translate complex quality risks into business impact.

Education

• Bachelor’s degree required or equivalent relevant work experience.