Full-Time

Majesco Billing Expert

Policy Expert, Claims Expert

Posted on 1/10/2026

Deadline 2/22/26
CVS Health

CVS Health

10,001+ employees

Healthcare, insurance, PBM, and retail pharmacy

Compensation Overview

$130.3k - $260.6k/yr

+ Bonus + Equity Grants + Commission

Company Historically Provides H1B Sponsorship

Hartford, CT, USA

In Person

Category
Engineering Management (1)
Requirements
  • Majesco Platform Expertise: Deep, hands-on experience with the Majesco LA&H Core Suite, including Policy Administration, Enrollment, Billing, and Claims modules. Experience with Majesco customizations, configuration, and API management is essential
  • System Stabilization and Optimization: Proven track record of successfully stabilizing complex, enterprise-level insurance platforms, including resolving high-volume defects and optimizing performance
  • Defect Management & Resolution: Extensive experience in defect triage, root cause analysis, and leading resolution efforts for critical business functionalities like enrollment, billing, and claims
  • Insurance Domain Expertise: In-depth understanding of the Supplemental/Voluntary insurance business, including product lifecycle management, enrollment processes, billing operations, claims adjudication, and industry regulations
  • Technical Proficiency: Strong proficiency in Java, SQL, database management (e.g., Oracle, SQL Server), and integration technologies
  • Collaboration & Communication: Exceptional communication and interpersonal skills to effectively collaborate with Aetna teams, Majesco technical support, and other stakeholders to achieve resolution
  • Leadership and Mentorship: Demonstrated ability to lead technical teams, guide problem-solving efforts, and influence positive outcomes in challenging technical environments
  • Problem-Solving & Analytical Thinking: Superior analytical and problem-solving skills to diagnose complex technical issues, identify root causes, and devise effective solutions
  • Relevant Experience: Minimum of 10+ years of experience in software engineering, with at least 5+ years in technical leadership or expert role involving Majesco implementation and significant experience in stabilizing complex IT environments and resolving high-impact defects
  • Education: Bachelor’s degree in computer science, Engineering, or a related field, or equivalent experience
  • Experience with SAFe Agile Development practices and processes: knowledge of SAFe practices is preferred
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
Desired Qualifications
  • Exposure to Majesco Intelligent Sales & Underwriting Workbench
  • Familiarity with DevOps pipelines, containerization (Azure/AWS), and CI/CD tools
  • Experience integrating Majesco with CRM/ERP systems
  • Experience with Gen‑AI extensions in Majesco (e.g. Copilot-based Chatbot)
  • Exposure to UI design or microservices architectures
  • Experience with SAFe Agile Development practices and processes
  • SAFe Practitioner certification is preferred

CVS Health operates as a diversified health services company in the United States, organized into Health Care Benefits, Pharmacy & Consumer Wellness, and Health Services. Its offerings include medical insurance products, retail and mail-order prescription drugs, and pharmacy benefit management (PBM) services, all connected through its integrated platform. By combining insurance, retail pharmacy, PBM, and health solutions, CVS Health coordinates care and controls costs across touchpoints for individuals, employers, and government programs. The company aims to lower health care costs while improving access and health outcomes for customers.

Company Size

10,001+

Company Stage

IPO

Headquarters

Woonsocket, Rhode Island

Founded

1963

Simplify Jobs

Simplify's Take

What believers are saying

  • Q1 2026 revenue exceeded $100B, up 6% year-over-year.
  • Medical benefit ratio improved to 84.6%, signaling better cost management.
  • Pharmacy-only locations in underserved areas drive medication access expansion.

What critics are saying

  • Amazon Pharmacy captures 20% urban market share with next-day delivery.
  • FTC settlement forces PBM margin cuts of 15-20% through transparency.
  • State-level spread pricing bans eliminate $2-3B annual pharmacy revenue.

What makes CVS Health unique

  • Integrated model combines insurance, pharmacy, and primary care clinics uniquely.
  • Over 800 MinuteClinic locations and 24/7 virtual care nationwide.
  • Aetna serves 26 million medical members with broad health plans.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Company News

PR Newswire
Mar 30th, 2026
CVS opens first pharmacy-only location in Chicago, plans nearly 20 this year

CVS Health has opened its first pharmacy-only location in Chicago, part of plans to launch nearly 20 such sites across the US this year. The 3,000-square-foot store at 2628 West Pershing Road features a full-service pharmacy with selected over-the-counter products. The pharmacy-only format is designed to increase access to medications, immunizations and pharmacist consultations in underserved communities. Additional locations are planned for Houston, Roxbury, Detroit and Brooklyn in 2026, alongside more than 40 traditional CVS Pharmacy stores. The move responds to consumer preferences, with CVS's 2025 research showing 80% of patients prefer face-to-face pharmacy care and 48% would switch pharmacies if limited to digital-only options. The company opened its first pharmacy-only site in Birmingham, Alabama, late last year.

Yahoo Finance
Mar 26th, 2026
CVS settles FTC insulin pricing probe as regulatory scrutiny of pharmacy benefit manager intensifies

CVS Health has reached a proposed settlement with the Federal Trade Commission over insulin pricing practices at its Caremark pharmacy benefit manager unit. The company also declared a quarterly dividend of $0.665 per share, payable on 4 May 2026. The settlement places CVS's pharmacy benefit management model under increased regulatory scrutiny regarding drug cost transparency. The company's investment narrative centres on its integrated model across insurance, pharmacy and care delivery, with near-term focus on restoring profitability in healthcare delivery and PBM services. CVS recently appointed former Elevance Health CFO John E. Gallina to its board as an audit committee financial expert. The company's narrative projects $445.5 billion revenue and $10.2 billion earnings by 2029, implying a fair value of $96.50 per share.

Yahoo Finance
Mar 23rd, 2026
Bernstein upgrades CVS Health to Outperform with $94 price target amid Medicare Advantage turnaround

Bernstein analyst Lance Wilkes upgraded CVS Health to "Outperform" from "Market Perform" on 12 March, raising the price target to $94 from $91. The upgrade reflects the company's attractive exposure to the Medicare Advantage turnaround and expectations of stable earnings in its pharmacy and pharmacy benefit manager businesses following reforms. Wilkes cited the PBM bill passage and the Federal Trade Commission settlement with Cigna as clearing events for the stock. Separately, CVS Health announced a strategic partnership with Google Cloud focused on reimagining healthcare experiences through its new health technology subsidiary, Health100, which will offer AI-powered healthcare services. CVS Health operates as a diversified healthcare company combining insurance, pharmacy benefit management, retail pharmacies and clinical services across the United States.

Yahoo Finance
Mar 13th, 2026
CVS Health's Aetna unit pays $117.7M to settle Medicare Advantage fraud allegations

Aetna, a CVS Health subsidiary, has agreed to pay $117.7 million to the US Department of Justice to settle allegations that it submitted inaccurate diagnosis codes for Medicare Advantage members to increase reimbursements. The settlement resolves longstanding False Claims Act allegations related to the Medicare Advantage programme. CVS Health shares recently closed at $76.07, down 5.1% year-to-date, though up 20.1% over the past year. The settlement is material for the company, which has thin net margins of 0.4% and debt not well covered by operating cash flow. The agreement highlights compliance risks in CVS Health's government-facing insurance operations, a central part of its Medicare Advantage business. Analysts' average target price stands at $96.50, approximately 27% above current levels.

Yahoo Finance
Mar 7th, 2026
Alphabet faces wrongful death lawsuit over Gemini AI chatbot while expanding healthcare partnership with CVS

Alphabet faces a wrongful death lawsuit alleging its Gemini AI chatbot contributed to a user's suicide, reportedly the first legal case directly linking Google's AI tools to a death. Simultaneously, the company announced a healthcare AI partnership with CVS Health focused on a real-time consumer engagement platform. The contrasting developments underscore Alphabet's expanding role in high-stakes sectors. The CVS collaboration integrates Gemini into Health100, a platform handling personal interactions across insurers, pharmacies and care providers. Meanwhile, the lawsuit tests whether conversational AI design and crisis protocols carry a duty of care, even outside formal healthcare settings. For investors, the key questions centre on how Alphabet manages legal risk, establishes guardrails and navigates regulatory oversight as its AI tools penetrate sectors requiring heightened safety and compliance standards.

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