Claims Systems, Business Solutions Lead Analyst - eviCore - Remote

eviCore; United States; Remote; USD 74,000 - 124,000; Full time

Job summary

An innovative division within a leading health services company is seeking a Claims Systems, Business Solutions Lead Analyst. This remote role offers the opportunity to manage complex projects, gather business requirements, and collaborate with various teams to ensure timely project delivery. Candidates should have a strong background in claims adjudication systems and advanced SQL skills. Join a forward-thinking organization that values growth and innovation, and make a significant impact in the healthcare sector while enjoying a competitive salary and comprehensive benefits.

Benefits

Medical insurance

Dental insurance

Vision insurance

401(k) with match

Paid time off

Qualifications

• 5+ years in Claims Adjudication System implementation/migration.
• Advanced SQL skills and knowledge of healthcare data standards.

Responsibilities

• Manage complex implementation and enhancement projects.
• Lead requirements gathering, training, and post-launch support.

Skills

Claims Adjudication System implementation

SQL

Healthcare data standards (X12, JSON, XML, Delimited)

Agile Methodology

Communication skills

Organizational skills

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

Join to apply for the Claims Systems, Business Solutions Lead Analyst - eviCore - Remote role at EviCore by Evernorth.

Overview

EviCore, a division within the Cigna Group, is seeking a Claims Systems, Business Solutions Lead Analyst to support implementations, expansions, and client support requests. The role involves gathering business requirements from internal and external clients, collaborating with various teams, and ensuring project delivery on time and within scope.

Key Responsibilities

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

Minimum Requirements

• High School diploma or GED; Bachelor’s in IT or Computer Science preferred.
• 5+ years in Claims Adjudication System implementation/migration or claim adjudication engine enhancement.
• Knowledge of healthcare data standards (X12, JSON, XML, Delimited).
• Strong understanding of claims adjudication processes.
• Advanced SQL skills.
• Proficiency with Microsoft Office, Excel, Visio, Confluence, and Smartsheet.
• Understanding of Agile Methodology.
• Excellent communication and organizational skills.
• Ability to travel as required.

Remote work requires internet with at least 10Mbps download and 5Mbps upload speeds.

Compensation & Benefits

Annual salary: $74,400 - $124,000, plus potential bonus. Benefits include medical, dental, vision, 401(k) with match, paid time off, and more.

About Evernorth

Evernorth Health Services creates innovative pharmacy, care, and benefit solutions to improve health outcomes. Join us in driving growth and making a difference.

Equal Opportunity

We consider all qualified applicants without regard to race, color, age, disability, sex, or other protected characteristics. Reasonable accommodations available upon request.