Dual Entry Plan Builder

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 Provides plan benefit review, interpretation and systematic setup essential for online viewing and processing related to Customer Service, Claims, Enrollment, Billing and Reporting in support of internal and external partners. Fundamental Components: Reviews benefit provisions to ensure compliance with state and federal mandates. Evaluation process may also include assessment of summary plan descriptions and other related documents prepared internally or externally by clients. Develops and executes implementation strategy consistent with client expectations; Ensures strategy is administered in accordance with all performance guarantee arrangements. Uses critical thinking and extensive knowledge of Meritain’s system and processes to evaluate impact of client requested exceptions and develops reasonable alternatives to satisfy client’s needs while minimizing impact on Meritain’s system and operations; Identifies, communicates and tracks cost sensitive items not included as part of the standard process and highlights them for consideration in the determination of rate adjustments or renewal activity. Collaborates on review, analysis and development of recommendations for the design of complex account and benefit structures based on customers’ objectives and Meritain’s system. Ability to utilize Meritain’s proprietary system for analytical coding of detailed customized plans rather than standard offerings. Effectively manages implementation and provides direction to fellow team members ensuring success of overall imple...