Senior State Health Benefits Plans Specialist #00047

DHRM • Richmond, VA

1d

About The Position

The Employee and Retiree Services Unit within the Office of Health Benefits at the Virginia Department of Human Resource Management administers health insurance and related benefit programs for Virginia agencies and political subdivisions. The unit ensures benefit communications, policies, and procedures are clear, accurate, and aligned with applicable laws, regulations, and contracts; supports agency Benefits Administrators; and serves as a central contact for employee and retiree appeals, questions, and concerns.

The Senior State Health Benefits Plans Specialist assists the Program Manager with administration and policy development for the health benefits program, helps develop relationships with plan administrators, and monitors plan performance. The specialist provides guidance to Benefits Administrators, employees, and retirees on policies and procedures, and handles complex inquiries, appeals, and complaints related to the State and Local Health Benefits programs. The position also works with specialists in the Employee Services Unit and provides guidance and instruction as appropriate.

Requirements

• Comprehensive knowledge of health benefits policies and practices, including program administration and compliance requirements.
• Strong analytical skills to evaluate complex information and apply policies and regulations accurately.
• Proficiency in computer applications for preparing correspondence and reports.
• Demonstrated 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 and development of health benefits 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 regarding policies and procedures.
• Handle complex inquiries, appeals, and complaints concerning the State and Local Health Benefits programs.
• Work with specialists in the Employee Services Unit and provide guidance and instruction as appropriate.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED