Claims Systems, Business Solutions Lead Analyst - eviCore - Remote

Lensa; Bloomfield (CT); Remote; USD 74,000 - 124,000; Full time

Job summary

An innovative firm is seeking a Claims Systems, Business Solutions Lead Analyst to enhance business solutions and support client interactions. This role involves managing complex projects, gathering requirements, and collaborating with various stakeholders to ensure successful implementation of claims systems. If you have a strong background in claims adjudication, excellent communication skills, and a passion for improving business processes, this is a fantastic opportunity to make a significant impact in the healthcare sector. Join a forward-thinking team dedicated to enhancing health outcomes through technology and collaboration.

Benefits

Health Coverage

401(k)

Paid Time Off

Annual Bonus Plan

Qualifications

• 5+ years of experience in claims adjudication systems implementation.
• Knowledge of healthcare data standards such as X12, JSON, XML.
• Strong understanding of end-to-end claims adjudication processes.

Responsibilities

• Manage multiple complex implementation and enhancement projects.
• Lead requirements gathering, training, testing, and post-launch support.
• Collaborate with clients and internal teams on feature development.

Skills

SQL

Communication Skills

Time Management

Agile Methodology

Education

High School diploma or GED

Bachelor’s in IT or Computer Science

Tools

Microsoft Office

Excel

Visio

Confluence

Smartsheet

Job description

Claims Systems, Business Solutions Lead Analyst - eviCore - Remote

3 days ago Be among the first 25 applicants

Lensa is the leading career site for job seekers at every stage of their career. Our client, The Cigna Group, is seeking professionals. Apply via Lensa today!

Ready to work with a team that improves our business solutions? Do you have a high degree of technical expertise in claims systems? eviCore, a line of business within the Cigna Group, is hiring a Claims Systems, Business Solutions Lead Analyst to provide focused support on implementations, expansions, and client support requests. The Lead Analyst will be responsible for gathering business requirements from internal and external clients, compiling them into comprehensive requirements for presentation to stakeholders. This role involves working closely with external clients, internal teams, project managers, and claims development teams to ensure project delivery within scope and on time.

What You'll Do

1. Manage multiple complex implementation and enhancement projects simultaneously.
2. Lead activities such as requirements gathering, training, testing, monitoring, and post-launch support.
3. Support client interactions and communication.
4. Guide clients and stakeholders on processes and impacts of requested changes.
5. Support feature/user story development.
6. Prioritize and manage tasks effectively using time management skills.
7. Ensure accurate and detailed requirements capture to prevent system issues.
8. Provide technical support to data analysts for system analysis, requirements writing, and data validation.
9. Collaborate with external clients and internal teams on feature development to ensure timely project delivery.

Requirements

• High School diploma or GED required; Bachelor’s in IT or Computer Science preferred.
• 5+ years of experience in claims adjudication systems implementation/migration or engine enhancement.
• Knowledge of healthcare data standards such as X12, JSON, XML, Delimited formats.
• Strong understanding of end-to-end claims adjudication processes.
• Advanced SQL skills.
• Proficiency in Microsoft Office, Excel, Visio, Confluence, and Smartsheet.
• Understanding of Agile methodology.
• Strong communication skills for stakeholder interfacing.
• Excellent organizational and time management skills.
• Ability to travel to client sites as needed.

Remote work requires internet speeds of at least 10Mbps download and 5Mbps upload via cable broadband or fiber optic service.

Salary range: $74,400 - $124,000 annually, depending on experience and location. Eligible for an annual bonus plan.

Benefits include health coverage, 401(k), paid time off, and more. Details at Life at Cigna Group.

About Evernorth Health Services

Evernorth, a division of The Cigna Group, provides pharmacy, care, and benefit solutions to improve health outcomes. Join us to innovate in health prediction, prevention, and treatment.

Qualified applicants are considered regardless of race, color, age, disability, sex, and other protected characteristics. For accommodations, email [e-mail].

The Cigna Group maintains a tobacco-free policy and considers criminal history in employment decisions.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Business Development and Sales
• Industries: IT Services and IT Consulting