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 ourselves accountable 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
The Senior Software Development Engineer – Mainframe (Claims) is a senior individual contributor responsible for developing, enhancing, and supporting enterprise claims adjudication and financial processing systems on the mainframe platform. This role focuses on building and maintaining COBOI, CICS, DB2, and batch applications that support accurate claim processing, pricing, and payment outcomes. The engineer works independently on moderately complex enhancements and production issues while collaborating with product, QA, operations, and downstream system teams. The role also supports regulatory changes, system stability, and payment integrity initiatives and contributes to modernization efforts impacting claims processing.
Key Responsibilities
Claims Application Development
- Design, develop, and enhance claims adjudication, pricing, and payment‑related mainframe applications
- Build and maintain COBOL programs supporting claim intake, edits, pricing, provider payment, and adjustments
- Develop and support CICS online transactions and high‑volume batch processing flows
- Implement business rules aligned with claims policy, benefits, reimbursement, and payment integrity logic
- Perform impact analysis for benefit changes, regulatory updates, and claim rule modifications
Production Support & Stability
- Perform abend analysis, root cause analysis (RCA), and defect remediation
- Partner with Operations and Application Support teams to meet SLA, SOX, and audit requirements
- Support release validation, checkouts, and production cycles for claims systems
- Participate in scheduled on‑call rotations when required
Data & Performance Optimization
- Optimize DB2 SQL for claims queries, extracts, and payment calculations
- Tune batch jobs and job streams to improve cycle time, batch window adherence, and CPU efficiency
- Identify and resolve data integrity issues impacting claim outcomes and provider payment
Integration & Modernization
- Support integration of mainframe claims platforms with downstream and upstream systems (vendor feeds, pricing engines, clinical edits)
- Participate in modernization initiatives such as service enablement, API exposure, and hybrid cloud integrations
- Collaborate with architects and senior SMEs on incremental modernization without impacting claims accuracy
Collaboration & Engineering Practices
- Work closely with:
- Claims product owners and business partners
- QA, UAT, and release teams
- Distributed application and data platform teams
- Contribute to:
- Code reviews
- Design discussions
- Technical documentation
- Mentor junior engineers and support consistent engineering standards
- Deliver work within Agile / Scrum delivery models
Required Qualifications
- 5–8+ years of hands‑on mainframe application development experience
- Strong proficiency in:
- COBOL
- CICS, DB2, VSAM
- JCL and enterprise batch scheduling (e.g., Control‑M, CA‑7)
- Demonstrated experience supporting claims adjudication or financial transaction systems
- Experience with mainframe tools such as ISPF, SDSF, Endevor, File‑Aid, Abend‑Aid
- Strong analytical and debugging skills with attention to detail
- Ability to work independently on complex enhancements with minimal oversight
Preferred Qualifications
- Experience in healthcare claims processing (commercial, government, or provider billing)
- Familiarity with claims edits, pricing logic, benefits determination, and payment adjustments
- Exposure to payment integrity, clinical edits, or utilization review systems
- Experience supporting regulatory or audit‑driven changes
- Prior experience working in large‑scale enterprise claims environments
Education
- Bachelor’s degree in Computer Science, Engineering, or related field, or equivalent professional experience
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$101,970.00 - $203,940.00
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: 05/10/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.