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Executive Director, Claim Platform Quality Assurance

AT CVS Health
CVS Health

Executive Director, Claim Platform Quality Assurance

Chicago, IL

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Position Summary

At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health's unrivaled presence in local communities and their pharmacy benefits management capabilities, we're joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.

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Aetna is recruiting for an Executive Director, Claim Platform Quality Assurance for the Claims Center of Excellence Automation team who will own the design and execution of the organization's claim platform test strategy. Lead programs for test domains, associated applications, and functional testing support teams. Develop methodology to achieve best in class quality, cost efficiency, and timely deliverables. Ensure compliance of product testing with organizational requirements.

You'll make an impact by:
  • Lead area processes for the organization's Quality Assurance area, and ensures methods align with the overall business strategy.
  • Lead test strategy development which includes components such as unit testing, user acceptance testing, end to end, regression testing, financial neutrality, performance testing, etc. across claims platforms.
  • Establish and monitoring the ongoing capabilities needed for an effective test environment.
  • Develop targeted and broad test scenarios with statistically valid volume that ensure benefits and contracts perform as expected.
  • Manage defect identification, resolution, and mitigation
  • Formulate organizational policies, goals, and objectives based on best practices in the field.
  • Deliver enhancement recommendations to standardize metrics and reporting.
  • Establish integration of standards with quality principles and methodology.
  • Design, develop, and re-engineer process improvement changes for the organization.
  • Develop relationships with technical and organizational leaders to ensure alignment and achievement of long-term testing vision.
  • Advise management on proposed process implementation and refinement issues.
  • Manage team performance through regular, timely feedback as well as the formal performance review process to ensure delivery of exceptional services and engagement, motivation, and team development.
  • Oversee unit's staffing headcount, vendor staffing/expense (as applicable) and overall financial performance to budget. Support attainment of key financial targets associated with reducing the impact of configuration defects that lead to operational rework expense and late claim interest penalty expense
Required Qualifications

The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company's business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes:
  • 10+ years of experience in Quality Assurance
  • 5+ years of experience in design and execution of test strategy, which includes components such as unit testing, user acceptance testing, end to end, regression testing, financial neutrality, performance testing, etc.
  • Adept at execution and delivery (planning, delivering, and supporting) skills
  • Adept at business intelligence
  • Adept at collaboration and teamwork
  • Mastery of problem solving and decision-making skills
  • Mastery of growth mindset (agility and developing yourself and others) skills
  • Ability to work in a hybrid work environment
Education Requirements

Bachelor's degree required or equivalent experience

Pay Range

The typical pay range for this role is:

$131,500.00 - $303,195.00

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. This position also includes an award target in the company's equity award program.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 11/01/2024

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

Client-provided location(s): Chicago, IL, USA
Job ID: CVS-R0377751_1002
Employment Type: Other

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • HSA
    • HSA With Employer Contribution
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Fertility Benefits
    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
  • Financial and Retirement

    • 401(K) With Company Matching
  • Professional Development

    • Tuition Reimbursement
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Diversity, Equity, and Inclusion Program