Job Description

Testing Subject Matter Expert (Sme) – Aetna Claim Adjudication System (Acas) Benefits

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.

At CVS Health, we are committed to building a world of health around every consumer, supported by passionate colleagues who strive to transform healthcare. As the nation's leading health solutions company, we serve millions of Americans through our local presence, digital channels, and a workforce of over 300,000 purpose‑driven professionals.

We are seeking a Testing Subject Matter Expert (SME) – Aetna Claim Adjudication System (ACAS) Benefits to join our Testing Center of Excellence (TCOE). This role is a hands‑on individual contributor responsible for executing, analyzing, and improving commercial benefits testing across ACAS. The Testing SME brings deep domain expertise in benefits configuration and claims adjudication and plays a critical role in identifying defects early, assessing risk, and strengthening testing effectiveness.

The ideal candidate is highly analytical, detail‑oriented, and comfortable operating independently while collaborating closely with business partners, configuration teams, and auditors.

Key Responsibilities

Hands‑On Testing & Analysis

• Execute end‑to‑end benefits testing in ACAS test environments, including complex and high‑risk scenarios.
• Design, review, and refine test cases to ensure accurate coverage of benefit configurations and business rules.
• Validate test results and analyze defects to determine root cause and downstream impact.

Defect Identification & Risk Assessment

• Identify configuration defects, data issues, and adjudication gaps prior to production release.
• Assess defect severity, claim exposure, and potential member or client impact.
• Partner with configuration and business teams to clarify requirements and expected outcomes.

Collaboration & Knowledge Sharing

• Act as a trusted testing SME for ACAS benefits, supporting analysts, auditors, and business stakeholders.
• Collaborate with SMEs and configuration teams to resolve issues and validate fixes.
• Share insights on recurring defect patterns and risk areas to inform upstream improvements.

Quality & Process Improvement

• Contribute to the development and continuous improvement of testing standards, templates, and best practices.
• Provide input into risk‑based testing approaches and test coverage decisions.
• Support efforts to reduce rework, revisions, and post‑release corrections through stronger testing rigor.

Documentation & Reporting

• Document test scenarios, results, and defect findings with clarity and precision.
• Provide clear, concise summaries of testing outcomes and risks to the broader TCOE and business teams.

Required Qualifications

• 3+ years of experience in benefits testing, quality assurance, or related functions.
• 5 + years of experience in healthcare
• 3 + years of strong hands‑on experience with claims adjudication systems and benefit configuration testing.
• Proven ability to analyze complex benefit designs and identify defects independently.
• Experience working with test cases, test data, and defect tracking tools.
• Strong attention to detail and analytical problem‑solving skills.

Preferred Qualifications

• Experience within the healthcare domain, particularly commercial benefits and claims processing.
• Familiarity with ACAS, PERS, or similar benefit configuration and adjudication platforms.
• Experience supporting risk‑based or scenario‑driven testing approaches.
• Knowledge of Agile or iterative delivery environments.
• Strong written and verbal communication skills, with the ability to explain complex issues clearly.

Education

Bachelor's degree required or equivalent work experience.

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range: $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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

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