Coordinator, Data Administration (Plan Design Analyst)

Job DescriptionSupport underwriting functions as directed by supervisor in support of strategic goals and key performance measures. Scope may include multiple products, markets, and financial arrangements. The work is task driven. Complexity of work increases as technical skills progress. - Performs medical & pharmacy product/benefit analysis to create and deliver new business and/or existing business renewal plan designs and case installation documents. - Produces timely and accurate results.- Analyzes input/outputs for reasonability (e.g., benefit validations, benefit summaries, etc.)- Performs administrative support functions as directed (e.g., input data, analyze results, report metrics, create plan designs, etc.) to achieve appropriate outcomes for internal and external constituents.- Reviews work with mentor/manager for accuracy and recommend benefit alternatives based on federal/state mandates and filings, Aetna standards, and business strategy. - Utilizes basic functionality of plan design tools, systems, and reference materials to produce accurate product/benefit information. - Identifies and collects information critical to decision making.- Anticipates questions and conveys case benefit specifics in a clear concise manner. - Maintains integrity of source data and/or data systems.- Assists department with projects or workgroups.#AetnaUWRequired Qualifications- Analytical, critical-thinking, and decision-making skills are essential.- Demonstrated success prioritizing work and the ability to multi-task in a fast-paced environment.- Demonstrated success in a production-oriented environment meeting or exceeding production targets.- Demonstrated success in collaborating with others to meet/exceed expectations.- Experience providing clear and concise written and verbal communications.- Knowledge of Microsoft Office products; knowledge of Word and Excel are particularly essential.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications- Knowledge of Aetna medical and specialty products, including pharmacy, via claims, product development, drafting, underwriting or installation experience, with knowledge of the Aetna systems supporting those products, is highly preferred.- Experience with CCI, PER/S, and Aetna claims systems a plus.Education- High School/GED or equivalent experience.- Bachelor's degree preferredBusiness OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2024-10-19