Senior QA Analyst (Clinical UM/CM Platforms)

CVS Health • Hartford, CT

2d

About The Position

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. Summary As a Senior QA Analyst, you will lead day-to-day quality assurance activities and support complex QA initiatives across clinical domain applications and platforms supporting Utilization Management (UM) and Care Management (CM) at CVSHealth. You’ll execute and improve QA review processes, evaluate complex cases, identify trends, conduct product testing and validation and drive continuous improvement in quality controls and workflows. You will partner closely with business stakeholders, architects, developers, and product delivery teams in an Agile environment to ensure new functionality is delivered with high quality, supports operational efficiency, and meets defined requirements. This is an individual contributor role with no direct supervisory responsibilities.

Requirements

• 5+ years of relevant experience in QA, audit, healthcare operations, or a related field.
• Demonstrated experience in issue/defect triage, complex problem solving, and driving process improvement.
• Strong analytical skills with the ability to identify trends and translate findings into actionable recommendations.
• Strong written and verbal communication skills; able to influence across stakeholders.
• Proficiency with MS Office tools (Excel, Word); comfort producing clear QA reporting.
• Experience working in an Agile/Scrum environment.

Nice To Haves

• Experience in regulated Clinical application (healthcare).
• SAFe Agile experience and familiarity with Rally (or similar Agile tooling).
• Exposure to clinical platforms and workflows supporting UM/CM.
• Experience with QA reporting tools and/or automation solutions.
• Working knowledge of application technology stacks and monitoring tools (e.g., APIs/microservices, SQL, Splunk, Dynatrace).
• Demonstrated ability to lead under pressure, adapt to changing priorities, and drive alignment across multiple teams.

Responsibilities

• Execute daily QA review activities and ensure adherence to QA protocols, standards, and documentation practices in support of Utilization and Care Management Clinical application
• Perform complex case reviews; identify defects, risks, and root causes; and provide guidance to support resolution.
• Analyze QA findings and production trends to recommend process improvements, prevention controls, and enhanced detection methods.
• Partner with cross-functional teams (business, architects, developers, QA peers, vendors, production support) to clarify requirements and ensure test coverage aligns to intended outcomes.
• Support System, Regression and UAT test planning, execution support, and sign-off readiness by validating test results and ensuring traceability to requirements.
• Participate in Agile ceremonies and delivery routines (PI planning, sprint planning, standups, retrospectives, demos) and maintain quality visibility across delivery milestones.
• Contribute to implementation of new QA tools, workflows, reporting, or automation capabilities.
• Communicate quality status, trends, and risks to leadership and stakeholders with clear data-driven insights and recommended actions.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees