Majesco Billing Expert / Policy Expert / Claims Expert

Overview

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. We do it all with heart, each and every day.

Position Summary

Aetna\'s Voluntary (supplemental) business requires an accomplished Technical Lead / Expert with extensive knowledge & experience of Majesco LA&H platform. This critical role involves addressing significant challenges related to enrollment, billing, and claims processing on the Majesco LA&H Core Suite. The ideal candidate will be a hands-on expert in resolving defects, optimizing system performance, and guiding both Aetna and Majesco technical teams towards a stable and efficient production environment.

Key responsibilities

• Lead Technical Stabilization & Defect Resolution : Take ownership of stabilizing the Majesco environment, particularly focusing on resolving high-priority defects and systemic issues impacting enrollment, billing, and claims processing
• Deep-Dive Analysis & Root Cause Identification : Conduct thorough analysis of existing issues, working closely with Aetna business and technical teams, and Majesco technical team to identify the root causes of recurring defects and performance bottlenecks
• Collaborate and Coordinate Resolution Efforts : Facilitate communication and collaboration between Aetna\'s technical teams (development, QA, operations), Majesco\'s technical support, and development teams to prioritize, escalate, and resolve open defects efficiently
• Drive Technical Design and Development : Guide the development and implementation of defect fixes, system enhancements, and necessary customizations within the Majesco platform, ensuring adherence to Aetna\'s technical standards and best practices
• Optimize System Performance : Identify and implement solutions to optimize the performance and scalability of the Majesco platform across Policy Administration, Enrollment, Billing, and Claims modules
• Enhance Integration Reliability : Ensure the stability and reliability of integrations between the Majesco platform and Aetna\'s front and backend systems, troubleshooting integration issues and optimizing data flow
• Mentor and Knowledge Transfer : Provide expert guidance and mentorship to Aetna\'s internal teams, fostering knowledge transfer and improving their ability to manage and support the Majesco platform
• Reporting and Communication : Provide regular updates to Aetna leadership on stabilization progress, key defect resolution efforts, and overall platform health

Required Qualifications

Preferred Qualifications

Education

Pay Range

The typical pay range for this role is :

$130,295.00 - $260,590.00

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.

Benefits

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.

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

We anticipate the application window for this opening will close on : 11 / 30 / 2025

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

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