EviCore by Evernorth · 1 day ago
Manager Claims Systems - EviCore - Remote
United States
Full-time
Remote
Senior Level
$87K/yr - $145K/yr
5+ years expEviCore by Evernorth is a division of The Cigna Group that creates pharmacy, care, and benefit solutions to improve health. The Manager of Claims Systems will oversee the day-to-day operations and ensure the successful completion and quality of claims systems deliverables, while also collaborating with various teams for process improvements and governance workflows.
Health CareHospitalMedical
Responsibilities
Oversight of Claims Systems initiatives change control, risk assessment/management, impediment removal, as well as progress reporting to the Director of Claims Systems and/or other leadership, as required
Collaborate with the Claims Business Process Solutions, Claims Business Intake Team and Claims Product and Planning team for claims backlog governance workflow input, process improvement initiatives and resource impediments solutions
Provide input, as needed, toward LBC and OC discussions with Claims Leadership and Product and Planning resources
Through personal execution or delegation, ensure creation/maintenance of departmental work instructions, policies and workflows required to ensure success of deliverables and transition of knowledge to team members and other internal departments
Provide final approval of department work instructions, policies, workflows and training, as well as ensure audits are performed to verify adherence is met appropriately and timely
Motivate and guide the department to meet and exceed all goals and objectives as set forth by leadership
Support team Supervisors and Trainers regarding knowledge growth (i.e. platform, program, process, etc.)
Support team Supervisors in personnel activities (i.e., time and attendance, recruitment, annual performance evaluations, payroll, disciplinary procedures, training, etc.)
Oversight of departmental audit control maintenance, adherence to audit controls and audit control artifacts are accessible upon request through collaboration with the Compliance team
Provide support to Claim Systems resources to overcome knowledge impediments or client escalations, which the Trainer and Supervisors are unable to overcome, through appropriate channels of support available both internally and externally
Qualification
Required
High School Diploma required
5+ years of healthcare claims life cycle and client/vendor relationship experience, with an emphasis in healthcare claims system configuration/implementations
2+ years of supervisor experience
Proficient in Excel, Word and Access, required
Experience in claims adjudication platform, maintenance and implementation required
Experience in Business Quality Assurance processes, required
Knowledge of Agile and Kanban, required
Strong analytical and critical thinking skills, required
Strong decision-making skills, required
Strong aptitude for process improvement, required
Strong communication skills, required
Ability to supervise, multitask and work independently in a fast-paced environment are essential skills for this position
Preferred
Bachelor's degree preferred
Knowledge of SQL data query
Knowledge of Jira board and dashboard management, a plus
Benefits
Medical
Vision
Dental
Well-being and behavioral health programs
401(k)
Company paid life insurance
Tuition reimbursement
A minimum of 18 days of paid time off per year
Paid holidays
Company
EviCore by Evernorth
EviCore by Evernorth (EviCore) offers proven, diversified medical benefits management solutions that help clients reduce costs while increasing quality of care for their members.
5001-10000 employees
H1B Sponsorship
EviCore by Evernorth has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (41)
2024 (28)
2023 (57)
2022 (46)
2021 (28)
Funding
Current Stage
Late StageTotal Funding
$300MKey Investors
TA Associates
2017-10-10Acquired
2014-01-10Private Equity
2010-11-10Private Equity· $300M
Leadership Team
Stephen Mengert
Chief Financial Officer
Recent News
Medical Product Outsourcing
2025-08-22
Company data provided by crunchbase