Business Project Specialist, Proclaim Benefit Utility - Evernorth - Remote

POSITION SUMMARY

The Business Project Lead Analyst will directly support the performance of the Proclaim Plan Automation and QA teams. Assists in daily operations by ensuring consistency in process and workflow as well as maintaining standard policies and procedures aimed at improving overall operational performance (e.g., quality and productivity). This role will serve as the business partner contact for Sales, key initiative enterprise project teams, baseline project teams, Claim, Product Service Partners, Product Benefit Advisory Board (PBAB), Exception Review Committee (ERC), and Systems. This role is responsible for maintaining effective relationships and meeting metrics for timely and accurate benefit automation end to end.

Primary Responsibilities Include

Leadership:

• Act as Benefits expert for Strategic Product & Service initiatives in a way that maintains or enhances operational Service, Productivity & Quality while fully meeting initiative objectives. Develop and share realistic Op Impact Assessments for these initiatives with both Operational Leads and Project teams.
• Works with management, technical coaches and training to implement action plans for change/improvement
• Ensures workflow consistency among teams, and across claim platforms to the extent possible
• Recommends process improvement to positively impact the quality and timeliness of Proclaim Benefits
• Develops innovative ideas for driving department results
• Serves as a business and technical resource for Tech Coaches and Management
• Business Partner Liaison:
  • Serves as Benefit Consultant for PBAB, ERC, Claims, Implementation and other service partners
  • Key Proclaim Plan Automation partner to ensure quality & timely templates, BOTs and macro builds
  • Contact for Production Support for definition and prioritization of system problems and enhancement requests.
  • Performs testing of Plan Automation function changes in lower IT regions prior to system releases and signs off on operational performance during system releases

Policies and Procedures:

• Provides clarification and direction on the appropriate application of specific protocols and Standard Operating Procedures as they relate to Proclaim Plan Automation and Product
• Ability to identify global trends related to Systems and Benefits to Management for training and coaching or other types of action plan development.
• Actively participates in providing coaching to employees when appropriate.
• Works with Trainer, front-line managers and QA to identify trends from quality data in order to develop action plans.
• Identify best practices for the organization and responsible for implementation.

Special Project Work:

• Participates and/or takes leadership role in special projects as requested.
• High level of proficiency on Proclaim Plan Automation and Claim Payment systems and processes
• Ability to drive a specific initiative with limited Management support

Key Qualifications

• High school or GED; Bachelor’s degree preferred
• 3+ years Proclaim Plan Automation experience
• Proficient knowledge of Plan Specs, ePro, Leg tool, Proclaim Claim System, Access, Word and Excel required
• Knowledge applying project management principles and methodologies
• Demonstrated business and technical acumen; technical experience in operations including, but not limited to, Benefits and Claim
• Self-starter mindset working autonomously with minimal direction
• Proven ability to work cross functionally with key stakeholders and business partners
• Demonstrated proficiency to troubleshoot and problem solve issues
• Excellent communication (oral and written), presentation, and facilitation skills
• Proficient using MS Office software

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 75,700 - 126,100 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.

At The Cigna Group, 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays