Sr Clinical Operations Specialist

Government Employees Health Association • Summit, MO

2d • Remote

About The Position

Government Employees Health Association, Inc. (G.E.H.A) is a nonprofit member association that provides health and dental benefits that millions of federal employees and retirees, military retirees and their families have counted on since 1937. Offering one of the largest health and dental benefit provider networks available to federal employees in the United States, G.E.H.A empowers health and wellness by meeting its members where they are, when they need care. G.E.H.A has one mission: To empower federal workers to be healthy and well. Performs complex administrative workflow tasks that support functions for the Clinical Operations team. Applies critical decision analysis and ability to independently create effective solutions to situations outside of a defined workflow. Engages and educates members and providers about G.E.H.A benefits and programs. Identifies cases for internal and external Clinical Operations programs.

Requirements

• Requires two years (60 credit hours) of college or 4 years of healthcare experience
• Minimum of 1 year of clinical operations experience
• Additional years of qualifying work experience may be considered in lieu of formal education.
• LPN license may be considered in place of experience.
• Requires intermediate proficiency with technology applications and systems.
• Requires proficiency Microsoft office products, i.e. Outlook, Excel, Word, Teams.
• Requires exceptional written and verbal communication skills.
• Must reside in Kansas City Metro region.
• Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
• A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
• Latency (ping) response time lower than 80 ms
• Hotspots, satellite and wireless internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Responsibilities

• Assists with delegated duties and tasks from the Clinical Operations Nurse team
• Assists members with contacting providers, community agencies, other Clinical Operations professionals, and other GEHA services.
• Identifies and refers cases that would benefit from internal and external GEHA programs.
• Identifies trends and recommends changes/improvements to aid in meeting or succeeding department goals.
• May assist or lead department training for new and upskilling performance needs.
• Assist with departmental testing and review of new technologies
• Other duties as assigned

Benefits

• Competitive pay/salary ranges
• Incentive plan
• Health/Vision/Dental benefits effective day one
• 401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
• Robust employee well-being program
• Paid Time Off
• Personal Community Enrichment Time
• Company-provided Basic Life and AD&D
• Company-provided Short-Term & Long-Term Disability
• Tuition Assistance Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree