Operations Lead Analyst
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Job Description
Operations Lead Analyst managing healthcare accumulator relationships for Evernorth Health Services. Resolving vendor issues, analyzing trends, and recommending process and technology improvements remotely from Tennessee.
Responsibilities:
- Build and maintain the Express Scripts relationship with third-party medical providers and health plan clients sharing accumulators for claims processing
- Manage day-to-day issues and inquiries, technology and connectivity, performance, and trending analytics
- Meet regularly with vendor teams to understand non-data trends and tactical business needs
- Navigate complex interactions with vendors and internal partners
- Recommend process improvements, systems upgrades, or technology changes to leadership
- Work within the CDH Triage team in a fast-paced, high-volume environment handling approximately 10K requests annually
Requirements:
- Consumer Driven Health (CDH) product understanding preferred but not required
- Working knowledge of upstream functional processes such as Accumulator Benefits, Modular Frames, Eligibility, and Claims Processing preferred but not required
- Ability to use data to identify opportunities and drive positive outcomes
- Strong communication skills and ability to understand complex relationships among medical providers, account teams, and internal functional/IT resources
- Ability to work cross-functionally and manage multiple requests/issues with competing deadlines
- Agility and ability to adapt to changing governmental regulatory requirements
- Ability to work independently and as part of a team with minimal oversight
- Ability to learn the end-to-end process
- Logical reasoning and attention to detail
- Strong problem-solving and critical-thinking skills
- High School diploma or GED required
- 3+ years of experience in a healthcare setting required; operations or significant cross-functional experience preferred
- Experience with Microsoft Office software preferred
- Demonstrated analytical, strategic planning, communication, and problem-solving skills preferred
- Demonstrated initiative and ability to work independently preferred
- Ability to work independently with moderate guidance and seamlessly within a larger team preferred
- Home internet connection through cable broadband or fiber optic service with at least 10Mbps download/5Mbps upload
Benefits:
- Remote work arrangement
- Work-from-home internet requirement of at least 10Mbps download/5Mbps upload through cable broadband or fiber optic service
- Reasonable accommodation support for the online application process
- Tobacco-free policy
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