CVS Health Plan Coordination Cnslt in Columbia, South Carolina
Processes and coordinates all plan benefit changes and required structural and administrative updates into systems essential for on-line viewing, claim enrollment and billing purposes.
Full or Part Time:
Percent of Travel Required:
0 - 10%
Posting Job Title:
Plan Coordination Consultant
Potential Telework Position:
Primary Location (City, State):
Aetna is an Equal Opportunity, Affirmative Action Employer
Additional Job Information:
Product knowledge.Strong team player.Superior customer service skills.Ability to manage multiple priorities.Excellent verbal and written communication skills.Problem solving skills.Attention to detail and accuracy.Analytical skills.
Analyzes and determines if products and services selected by customers are aligned with their benefit needs, and can be adequately supported by existing systems or operating platforms; additionally, seeks solutions and negotiates essential requirements in support of any non-standard plan selections.
Consults and communicates with internal constituents regarding the details associated with new business and revision activity in a timely manner and validates account structure.
Completes 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 products and services; May perform additional plan sponsor administration functions.
Reviews benefit provisions to ensure compliance with state and Federal legislative mandates; evaluation process may also include assessment of summary plan descriptions and other related documents prepared by the plan sponsor or third party.
If required, communicates revisions essential for supporting and guarding the plan against any unintended liability.
Monitors and manages internal installation process and maintains case tracking tools to meet constituents expectations and business goals.
Prepares complex employer contracts, custom contracts and/or employee custom certificates of coverage.
Completes required data input into performance measurement systems in support of key business and management initiatives.
- Prefer a candidate that is familiar with Aetna systems and that has a prior PCC background.
Benefit eligibility may vary by position.
Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
Clinical Licensure Required:
- CVS Health Jobs