Claims Systems, Technical Lead Analyst - eviCore - Remote

Cigna; Bloomfield (IA); Remote; USD 74,000 - 124,000; Full time

Job summary

Join a forward-thinking company as a Claim Systems Technical Lead Analyst, where your technical and analytical expertise will be pivotal in managing complex client implementations. In this role, you will bridge the gap between business and IT, ensuring precise requirements are captured and projects are delivered on time. With a focus on enhancing claims adjudication processes, you will lead initiatives that drive innovation and improve health outcomes. Enjoy a comprehensive benefits package, including health insurance, 401(k) matching, and generous paid time off. This is a unique opportunity to make a significant impact in the healthcare industry.

Benefits

Health insurance

401(k) with company match

Tuition reimbursement

Paid time off

Paid holidays

Life insurance

Behavioral health programs

Qualifications

• 5+ years of experience in Claims Adjudication System implementation.
• Strong knowledge of healthcare industry data standards.
• Proficient in SQL and API usage.

Responsibilities

• Manage concurrent implementation and enhancement projects.
• Lead requirements gathering and technical writing activities.
• Support clients in understanding changes to claims processes.

Skills

Claims Adjudication System implementation

System analysis

Technical writing

Data validation

SQL

API

Communication skills

Organizational skills

Agile Methodology

Education

High school diploma or GED

Bachelor's degree in Information Technology or Computer Science

Tools

Microsoft Office

Excel

Visio

Confluence

Smartsheet

Job description

Ready to work with a team that improves our business solutions? Do you have a high degree of technical and analytical expertise? EviCore a line of business within the Cigna group, is hiring Claim Systems, Technical Lead Analyst. For this highly technical and analytical role. You'll gather requirements across several disparate systems and compile them into a comprehensive functional set of requirements for presentation to internal and external stakeholders. This position will ultimately be a technical role - requiring system analysis, technical requirements writing, data validation and both internal and external cross-departmental interfacing. You'll perform as a bridge between business and IT counterparts to manage multiple, concurrent client implementations and enhancement projects.

What You'll Do:

• Manage multiple, concurrent implementation and enhancement projects with a high degree of complexity and system analysis
• Lead implementation, enhancement, and process improvement activities such as requirements gathering, technical writing, system analysis, data and configuration design, data validation, training, testing, monitoring of deliverables/tasks, post launch warranty support
• Own client interactions and communications in implementation and enhancement projects guiding clients to the best solutions
• Ensure requirements are captured correctly with the most precise detail, preventing significant issues in system implementation
• Support sponsors/requestors in understanding the impact of requested changes to end-to-end claims adjudication processes
• Use your technical proficiency to provide training and support to our technical data analysts for system analysis, technical requirements writing, and data validation
• work closely with external clients, internal stakeholders, project managers, claims systems, claims product and planning and claims development teams on feature/user story development to ensure projects are delivered on time and within scope.

Requirements:

• High school diploma or GED required, bachelor's degree in information technology, or computer science, highly preferred
• Knowledge of healthcare industry data standards and formats - X12, HL7, FHIR, etc. JSON, XML, Custom Delimited, etc.
• 5+ years of Claims Adjudication System implementation/migration and/or claim adjudication engine enhancement experience
• Experience in functional or software requirements development
• Strong knowledge of end-to-end claims adjudication processes
• Competent level of understanding of SQL and API
• Solid understanding of conditional logic
• Proficient technology skills including Microsoft Office, Excel, Visio, Confluence, and Smartsheet
• Understanding of Agile Methodology
• Strong organizational, time management skills with ability to prioritize tasks effectively
• Strong communication skills (interfacing between external and internal stakeholders)
• Ability to travel to client sites as required

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 74,400 - 124,000 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: [e-mail] for support. Do not email [e-mail] for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.