Plan Coordinator Consultant - Work From Home

Job DescriptionFacilitates the loading of Prior Carrier Plan accumulators or HRA contributions, via electronic data files or manual entry from prior plan Explanation of Benefits (EOBs), to assure members are given prior carrier credits, applicable HRA contributions and/or to allow for Stop Loss filings.Required QualificationsMonitors and manages internal installation process and maintains case tracking tools to meet clients expectations and business goals. (UAT and auditing are performed on each client load.) If required, communicates revisions essential for supporting and guarding the plan against unintended liability. Review data files within 24 hours to determine if the file is complete and contains the data elements required for loading. Consults and communicates with internal constituents regarding the details associated with new business and revision activity in a timely manner and validates account structure. Entry and follow through of the RTC ticket for IT assistance required to load the data files, including but not limited to:o creating a thorough test plan and performing the User Acceptance Testing (UAT) associated with the ticket.o Providing the applicable date ranges to be usedo Providing the applicable directive on type of claims to be loaded (medical, vision, Dental, Rx)o Providing the applicable directive for inclusion or exclusion claims for stop loss filing Completes require data input into performance measurement system in support of Key business and management initiatives. (tracking is done in Salesforce.)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 QualificationsHealthcare industry experience (Customer Service, Claims, and or Plan Build preferred) Detail oriented Highly organized Good communication skillsEducation5 years healthcare industry experience with benefitsBusiness 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: 2025-09-06