Claims Systems, Technical Lead Analyst – eviCore – Remote

eviCore; United States; Remote; USD 80,000 - 110,000; Full time

Job summary

An established industry player is seeking a Claims Systems, Technical Lead Analyst to bridge business and IT teams. This remote role involves managing complex projects, gathering requirements, and ensuring optimal solutions in claims adjudication processes. The ideal candidate will have extensive experience in claims systems implementation, strong technical skills in SQL and APIs, and a solid understanding of healthcare data standards. Join a diverse and inclusive workplace that values your contributions and offers opportunities for growth and development.

Qualifications

• 5+ years of experience in Claims Adjudication System implementation.
• Strong knowledge of healthcare data standards.
• Proficiency in SQL and APIs.

Responsibilities

• Manage complex implementation and enhancement projects.
• Lead requirements gathering and system analysis activities.
• Collaborate with clients and internal teams for project delivery.

Skills

SQL

APIs

Healthcare data standards (X12, HL7, FHIR, JSON, XML)

Stakeholder management

Technical writing

System analysis

Data validation

Organizational skills

Education

High school diploma or GED

Bachelor’s degree in IT or Computer Science

Job description

Claims Systems, Technical Lead Analyst – eviCore – Remote

Join to apply for the Claims Systems, Technical Lead Analyst – eviCore – Remote role at EviCore by Evernorth.

This highly technical and analytical role involves gathering requirements across multiple systems, compiling them into comprehensive functional specifications, and acting as a bridge between business and IT teams. You will manage client implementations and enhancements, perform system analysis, and support data validation and technical requirements documentation.

Responsibilities

• Manage multiple complex implementation and enhancement projects.
• Lead activities including requirements gathering, technical writing, system analysis, data validation, training, testing, and post-launch support.
• Communicate with clients and internal stakeholders to ensure optimal solutions and accurate requirement capture.
• Support the understanding of change impacts on claims adjudication processes.
• Provide training and support to technical data analysts.
• Collaborate with external clients, project managers, and internal teams to ensure timely project delivery.

Minimum Requirements

• High school diploma or GED required; bachelor’s degree in IT or Computer Science preferred.
• Knowledge of healthcare data standards (X12, HL7, FHIR, JSON, XML, etc.).
• 5+ years of experience in Claims Adjudication System implementation or enhancement.
• Experience in requirements development and understanding of claims processes.
• Proficiency in SQL, APIs, and conditional logic.
• Strong organizational, communication, and stakeholder management skills.
• Ability to travel as needed.

Additional details about salary, benefits, and company information are included in the original description. The role emphasizes diversity and equal opportunity employment policies.