Senior Manager Medicare Testing

CVS Health•Work At Home-Connecticut, CT

1d•$82,940 - $182,549

About The Position

Aetna is seeking a Senior Manager for the Test Center of Excellence team. The role oversees the design and implementation of test strategy and process governance, leads test programs across domains, applications, and functional testing support teams, and develops methodologies to deliver high quality, cost efficiency, and timely results. The position leads Quality Assurance processes in alignment with business strategy and partners with Medicare, HealthEdge Source, business, and technology stakeholders to achieve long-term testing objectives. The role covers testing across claims platforms, including Medicare pricing and HealthEdge Source-related testing. It includes establishing effective test-environment capabilities; creating statistically valid, comprehensive scenarios to test benefits, contracts, provider and configuration data, and claims; and managing defect identification, resolution, and mitigation. The Senior Manager also improves metrics and reporting, integrates quality standards and methodologies, implements process improvements, advises management on testing risks and quality considerations, and develops team performance through feedback, evaluations, and engagement.

Requirements

At least 7 years of experience in Quality Assurance.
At least 5 years of experience designing and executing test strategies, including unit, user acceptance, end-to-end, regression, financial neutrality, and performance testing.
Multiple years of proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes.
Knowledge of Medicare lines of business.
Experience with HealthEdge Source or comparable healthcare claims pricing platforms, including the ability to interpret pricing behavior, configurations, release changes, defects, and expected claim outcomes.
Ability to travel up to 10%.
Bachelor’s degree or equivalent experience.

Nice To Haves

Experience supporting HealthEdge Source release and regression testing, including analysis of pricing changes, historical defects, and production claim scenarios.
Ability to translate Medicare and Source subject-matter expertise into test scenarios, expected outcomes, defect analysis, and reusable testing knowledge.

Responsibilities

Lead and oversee Quality Assurance processes in alignment with the organization’s overall business strategy.
Develop and lead test strategies covering unit, user acceptance, end-to-end, regression, financial neutrality, and performance testing across claims platforms, including Medicare pricing and HealthEdge Source-related testing.
Establish and monitor the ongoing capabilities required for an effective test environment.
Create targeted, comprehensive test scenarios with statistically valid volume to assess benefits and contracts, including Medicare pricing, provider, configuration, and claim scenarios.
Manage defect identification, resolution, and mitigation, including analysis of Source-related pricing and claims behavior and validation of expected versus actual outcomes.
Recommend enhancements to metrics and reporting standardization.
Integrate standards with quality principles and methodologies.
Design, develop, and implement organizational process improvements.
Build relationships with technical and organizational leaders and partner with Medicare, Source, business, and technology stakeholders to align on long-term testing objectives.
Advise management on process implementation and refinement, including Medicare and Source testing risks, coverage, and quality considerations.
Manage team performance through regular feedback, timely evaluations, and fostering engagement, motivation, and team development.