Lead Director - Commercial; ACAS) Quality Assurance

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.

CVS Health is seeking a strategic and transformational Lead Director, Commercial Plan and Benefit Quality Assurance to lead quality and testing strategy for Aetna's Commercial line of business with a primary focus on the ACAS claims platform
. This role will serve as a key leader within the Testing Center of Excellence (Testing COE), responsible for advancing quality outcomes across claims processing, provider contracts, benefit configuration, pricing, and Open Enrollment readiness.

The Lead Director will drive the transformation of testing from a traditional defect-detection model into a proactive quality engineering and quality control capability focused on reducing claims rework, improving payment accuracy, enhancing provider and member experience, and mitigating operational risk.

This leader will partner closely with Business, Operations, Product, Technology, and vendor organizations to establish quality as a strategic business enabler. Additionally, the role will be responsible for modernizing testing capabilities through AI, automation, advanced analytics, and quality engineering practices to improve testing effectiveness, optimize delivery costs, and accelerate business value realization.

• Develop and execute the quality strategy for the Commercial business and ACAS claims platform, aligning quality initiatives with organizational goals and business outcomes.
• Drive Aetna wide quality transformation focused on reducing claims rework, improving first-pass accuracy, and strengthening operational excellence.
• Establish quality governance frameworks that proactively identify and mitigate risks before they impact members, providers, or business operations.
• Serve as a trusted advisor to senior leadership on quality, operational readiness, risk management, and continuous improvement opportunities.

• Lead initiatives that improve member and provider experiences through enhanced quality controls, defect prevention, and improved production stability.
• Partner with Operations and Business leaders to identify root causes of claims rework and implement sustainable quality improvements.
• Drive improvements in payment accuracy, claims processing quality, and release readiness across Commercial products and services.
• Establish measurable quality outcomes that demonstrate value through reduced rework, increased efficiency, and improved customer satisfaction.

• Oversee end-to-end testing strategy and delivery across provider contracts, claims processing, benefit configuration, pricing validation, implementations, and Open Enrollment readiness.
• Ensure comprehensive testing coverage through risk-based approaches across functional, integration, end-to-end, regression, financial neutrality, performance, and user acceptance testing.
• Lead defect management processes, root cause analysis, and continuous improvement initiatives to reduce production defects and operational disruptions.
• Build scalable testing capabilities, standards, methodologies, and governance processes that support growth and quality objectives.

• Define and execute a strategic roadmap for testing modernization through AI, automation, and quality engineering practices.
• Drive adoption of intelligent automation solutions to improve testing efficiency, expand coverage, accelerate execution, and reduce manual effort.
• Leverage AI-enabled capabilities for test design, test data generation, defect prediction, root cause analysis, production monitoring, and quality insights.
• Continuously optimize testing processes, operating models, and resource utilization to improve effectiveness and reduce delivery costs.
• Establish metrics and dashboards that measure automation value, testing effectiveness, productivity improvements, and business impact.

• Lead, develop, and mentor a high-performing organization of quality professionals.
• Foster a culture of accountability, innovation, continuous…