A Senior Manager in ACAS Provider Contract Testing is a critical leadership role within the healthcare payer and insurance technology sector. This profession sits at the intersection of complex healthcare claims systems, contractual agreements, and rigorous quality assurance. Professionals in these jobs are responsible for ensuring that the digital systems which process provider payments—specifically the Aetna Claim Adjudication System (ACAS) or similar platforms—accurately reflect the intricate terms of commercial contracts. Their work is foundational to financial integrity, regulatory compliance, and provider satisfaction, making these roles highly strategic and impactful. Typically, individuals in this position lead a dedicated testing team or function within a Testing Center of Excellence (TCOE). Their core mission is to govern and oversee the end-to-end testing lifecycle for contract changes before they go live. This involves translating complex legal and financial contract terms into testable system requirements and validating that the claims adjudication engine processes claims correctly according to those terms. Common responsibilities include establishing and enforcing robust governance frameworks for testing processes, managing stakeholder communication across business, IT, and compliance units, and providing executive-level reporting on quality metrics, risks, and project status. They are the escalation point for critical issues, tasked with proactive risk mitigation to safeguard project timelines and system accuracy. The day-to-day duties often encompass strategic planning, resource allocation, and process optimization. A Senior Manager mentors team members, fosters a culture of continuous improvement, and champions the adoption of automation and innovative testing methodologies to enhance efficiency and coverage. They act as a bridge, ensuring that the technical execution by IT teams aligns perfectly with business objectives and contractual obligations. Typical skills and requirements for these leadership jobs include extensive experience (often 5+ years) in both people management and the specialized domain of healthcare claims adjudication and contract testing. A deep, hands-on understanding of systems like ACAS is paramount. Candidates must demonstrate proven expertise in program/project management, stakeholder management, and governance. Strong analytical abilities, exceptional communication skills for liaising with both technical and non-technical audiences, and a keen eye for detail are essential. A bachelor’s degree in a relevant field or equivalent experience is commonly required, along with a proactive, self-starting attitude suited for dynamic environments. Ultimately, this profession is for those who excel at transforming contractual complexity into operational certainty, ensuring that provider payments are always accurate and compliant. For those with this unique blend of healthcare expertise and leadership acumen, Senior Manager, ACAS Provider Contract Testing jobs offer a challenging and rewarding career path at the heart of healthcare administration.
