Lead Director - Commercial (ACAS) Quality Assurance
Core
Lead quality and testing strategy for Aetna's Commercial line of business, focusing on the ACAS claims platform to reduce claims rework and improve payment accuracy.
Role type
Senior IC Lead Director, Commercial Plan and Benefit Quality Assurance
Builds
Quality governance frameworks, scalable testing capabilities, and AI-driven automation solutions for claims processing and benefit configuration.
Domain
Healthcare / Insurance / Claims Processing
Required skills
Strategic quality leadership, enterprise-wide testing strategy design, organizational transformation, cross-functional alignment, risk management, stakeholder management, analytical thinking, team leadership, hybrid work adaptability
Preferred skills
ACAS claims platform expertise, PERS and APC applications knowledge, end-to-end case installation lifecycle management, Open Enrollment readiness planning, operational defect reduction, quality control development
Technologies
AI, automation, advanced analytics, quality engineering practices
Responsibilities
Develop and execute quality strategy for the Commercial business and ACAS claims platform; Drive Aetna-wide quality transformation to reduce claims rework; Establish quality governance frameworks to mitigate risks; Lead initiatives to improve member and provider experiences; Oversee end-to-end testing strategy across provider contracts, claims processing, and benefit configuration; Define and execute a roadmap for testing modernization through AI and automation; Lead, develop, and mentor a high-performing organization of quality professionals
Seniority
Director, strategic leadership & hands-on execution
