Sr. Manager, Provider Contract and Pricing Testing

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary
At CVS Health, we are dedicated to building a world of health around every consumer, surrounded by passionate colleagues who are committed to transforming healthcare. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels, and a workforce of over 300,000 purpose-driven colleagues. We care for people where, when, and how they choose, in a way that is uniquely more connected, convenient, and compassionate. We do it all with heart, every single day.

We are seeking a Senior Manager of Provider Contract & Pricing Testing to join our expanding Testing Center of Excellence. This role requires a dynamic leader with extensive experience in provider and contract testing, test automation, and quality assurance. You will be responsible for managing a team of quality assurance engineers and analysts to implement and maintain effective testing processes, procedures, strategies, and automation tools for delivering high-quality provider contracts and pricing changes to our clients.

Key Responsibilities:

• Quality Leadership: Oversee the quality assurance of Provider Contracts and Pricing, ensuring that both Provider and Member Experiences meet or exceed expectations through the use of test automation tools.
• Automation: Collaborate with IT to support a robust testing automation framework for Provider & Contract Testing, driving the adoption and optimization of automation tools and implementing innovative approaches using proven technologies.
• Team Development: Mentor and motivate team members to reach their full potential while promoting industry best practices in Quality Assurance and Testing.
• Sr Leadership Reporting: Deliver comprehensive quality reports on Provider & Contract Testing outcomes, making informed recommendations and taking appropriate actions based on the data.
• Talent Development: Build a high-performing team by providing opportunities, guidance, and constructive feedback, while creating a talent pipeline for future growth.
• Technical Guidance: Set team direction, resolve challenges, and provide technical support to ensure development objectives are met.

Required Qualifications:
The ideal candidate will possess a strong work ethic, be a self-starter, and thrive in a dynamic, collaborative environment. Key attributes include:

• 5+ years of experience managing quality assurance projects.
• 5+ years of experience in provider contract testing, claims adjudication systems, quality assurance, or related functions.
• 5+ years of experience in managing, collecting, and analyzing testing metrics for reporting and delivery.
• Proven program and project management experience, including the creation and management of integrated plans to ensure predictable outcomes.
• Experience leading large integrated project plans and driving IT development to meet specific business needs.

Preferred Qualifications:

• Experience with commercial, individual exchange, and Medicare programs.
• Mastery of problem solving and decision-making skills

Education:
Bachelor’s degree required or equivalent work experience.

Pay Range

The typical pay range for this role is:

$82,940.00 - $182,549.00

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.

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.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 05/31/2025

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