Senior State Health Benefits Plans Specialist #00047
About The Position
The Employee and Retiree Services Unit within the Office of Health Benefits (OHB) at the Virginia Department of Human Resource Management administers health insurance and related benefit programs for Virginia agencies and political subdivisions. The unit supports Benefits Administrators with day-to-day program administration, ensures benefit communications and policies align with applicable laws, regulations, and contracts, and serves as a central contact for employee and retiree inquiries, appeals, and concerns. The Senior State Health Benefits Plans Specialist assists the Program Manager with administering the health benefits program and developing its policies. The position works with the Program Manager to maintain relationships with plan administrators and monitor plan performance. It provides policy and procedural guidance to Benefits Administrators, employees, and retirees; handles complex inquiries, appeals, and complaints concerning State and Local Health Benefits programs; and works with and provides guidance to Specialists in the Employee Services Unit.
Requirements
- Comprehensive knowledge of health benefits policies and practices, including program administration and compliance requirements.
- Strong analytical skills to evaluate complex information and accurately apply policies and regulations.
- Proficiency in computer applications for preparing correspondence and reports.
- Ability to communicate effectively orally and in writing.
- Strong organizational and time-management abilities, including setting priorities, working independently, and meeting objectives with minimal supervision.
- Demonstrated customer service skills.
- High school graduate or equivalent.
Nice To Haves
- Experience with medical claims.
- Background in utilization review.
- Experience, certification, or education in health benefits.
- Experience in policy development.
Responsibilities
- Assist the Program Manager with administration of the health benefits program and development of program policies.
- Work with the Program Manager to develop relationships with plan administrators and monitor plan performance.
- Provide guidance and advice to Benefits Administrators, employees, and retirees on policies and procedures.
- Handle complex inquiries, appeals, and complaints related to State and Local Health Benefits programs.
- Work with Specialists in the Employee Services Unit and provide guidance and instruction as appropriate.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
