EverNorth Home Delivery production systems require investigation and resolution of issues to ensure system integrity and patient safety, aligning with client and EverNorth objectives.
Requirements
- Proficiency within applications: Bluezone, TMW, CSP, Universal Viewer, Autofax, BE PAC Tool, POC, Alpha
- Proficiency in primary and secondary claims processing
- Understanding and ability to write business requirements.
- Data analysis and reporting skills.
- Experience working in an Agile environment preferred.
- PC skills including knowledge of Microsoft Office.
- Provides technical analysis in resolving system issues.
Responsibilities
- Prioritizing, investigating, and, where necessary, resolving issues with EverNorth Home Delivery production systems.
- Collaborate with development to help with collecting requirements, test cases, reviewing and approving test case output, and, as necessary, coordinating release validation with operations.
- Provides technical analysis in resolving system issues.
- Manages the configuration of the business rules that drive system functionality.
- Uses SME expertise to work cross functionally with other operational and division departments to research and resolve strategic and division wide projects and issues.
- Work collaboratively with operations and cross functional partners on root cause analysis and triage of incidents.
- Aids in the configuration of business rules that drive system functionality.
Other
- Bachelor’s degree in relevant discipline preferred or equivalent years’ experience.
- 5 plus years relevant operations experience
- Experience and understanding of specialty operations and processes is highly preferred.
- Knowledge of the PBM or healthcare industry preferred.
- Strong oral and written communication skills as well as presentation abilities
