Plan Implementation Sr. Representative - Evernorth - Remote

The Plan Implementation Sr. Representative is responsible for managing provider demographic and reimbursement data, implementing new networks, and ensuring data accuracy and integrity. The ideal candidate will have experience working with Proclaim or HCPM, proficiency in MS Office, and strong technical and analytical skills.

Requirements

• Selects, implements, and loads the system applications that administer managed care contract provisions
• Coordinates implementation and verification of the loading of fee schedules
• Creates and maintains networks and delivery systems in provider file system
• Responsible for successfully managing the tasks associated with the implementation of new networks
• Reviews, researches, and investigates root cause for claim and fallout issues using various systems
• Performs root cause analysis and individual outreach resolution using various tools and databases

Benefits

• 401(k)
• Company paid life insurance
• Tuition reimbursement
• Minimum of 18 days of paid time off per year
• Paid holidays
• Medical
• Vision
• Dental
• Well-being and behavioral health programs