Implementation Specialist (Meritain Health)

CVS Health

1d

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Implementation Specialist manages and coordinates benefit plan implementation for new and existing customers. This person provides focused service, fostering strong relationships with internal business partners, in order to assure all group implementation and administrative updates are loaded correctly.

Requirements

• 1+ year of experience in health care.
• High school diploma or GED.

Nice To Haves

• 3+ years of experience in health care.
• Previous experience in medical group implementation.
• Previous experience working with medical data files.
• Detail-oriented.
• Strong analytical skills.
• Excellent multi-tasking ability.
• Associate’s degree or higher.

Responsibilities

• Analyzing and determining if products and services selected by clients are aligned and can be adequately supported by existing systems or operating platforms; additionally, seeking solutions and negotiating essential requirements in support of any non-standard plan selections.
• Requires dynamic decision making to appropriately structure the group setups within the Meritain system to align with our vendor partners (Pharmacy Benefit Managers, Managed Care Entities, etc.) and analytics vendors, and provide the required structure for client billing and reporting.
• Actively consulting and communicating with internal staff regarding the details associated with new business and revision activity in a timely manner, as well as validating account structure.
• Completing timely and accurate set-up of complex account structure and detailed benefit plans in systems (for multiple constituents), in order to satisfy both internal and external deadlines for production, impacting a wide variety of products and services.
• Monitoring and managing internal installation process, as well as maintaining case tracking to meet constituents’ expectations and business goals.
• Maintaining data files for monthly group reporting, assuring PHI (Personal Health Information) guidelines are being followed.
• Running monthly reports for all clients and brokers.
• Responding to escalated issues related to group setup.
• Assisting with the development and testing of new or enhanced group setups.
• Providing technical expertise to team/unit, mentoring junior staff members, and assisting with the development and implementation of training tools and processes.
• Running adhoc data programs to assist with streamlining setup of group and eligibility files.
• Running adhoc data programs to quickly audit setup of customized group enrollments.
• Partnering in projects with our Products and IT teams to add/enhance products and services.
• Serving as the point person for testing of all changes related to the ER/EO/GIM data files.
• Performing other duties as needed.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees