Executive Director, Claim Platform Quality Assurance

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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.

Aetna is recruiting an Executive Director for Claim Platform Quality Assurance within the Claims Center of Excellence Automation team. This role involves owning the design and implementation of the organization's claim platform test strategy. The appointed leader will oversee programs for test domains, related applications, and functional testing support teams. They will also develop methodologies to uphold top-notch quality, cost efficiency, and timely deliverables. Moreover, ensuring product testing compliance with organizational standards is a key responsibility.

You'll make an impact by:

• Leading area processes for the organization's Quality Assurance area, and ensures methods align with the overall business strategy.

• Leading 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. 

• Establishing and monitoring the ongoing capabilities needed for an effective test environment.

• Developing targeted and broad test scenarios with statistically valid volume that ensure benefits and contracts perform as expected.

• Managing defect identification, resolution, and mitigation

• Formulating organizational policies, goals, and objectives based on best practices in the field.

• Delivering enhancement recommendations to standardize metrics and reporting.

• Establishing integration of standards with quality principles and methodology.

• Designing, developing, and re-engineering process improvement changes for the organization.

• Developing relationships with technical and organizational leaders to ensure alignment and achievement of long-term testing vision.

• Advising management on proposed process implementation and refinement issues.

• Managing 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.

• Overseeing the unit's staffing headcount, vendor staffing/expense (as applicable) and overall financial performance to budget.

• Supporting 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

• Supporting CVS Health in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve.

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 strategies.

• 5+ years of experience in design and execution of test strategies, which includes components such as unit testing, user acceptance testing, end to end, regression testing, financial neutrality, performance testing, etc.  

• 5+ years of leadership experience with a demonstrated track record of strong team performance and people development.

• Embraces an entrepreneurial mindset involvi