Senior State Health Benefits Plans Specialist #00047

Commonwealth of VA Careers; Richmond (VA); On-site; USD 85,000 - 100,000; Full time

Job summary

Commonwealth of VA Careers is seeking a Senior State Health Benefits Plans Specialist Senior in Virginia to support the Office of Health Benefits. The role focuses on administering health insurance programs for state agencies and political subdivisions, handling complex inquiries, and ensuring accurate communications and compliance with laws and contracts.

The position collaborates with the Program Manager to develop policies, build relationships with plan administrators, monitor performance,

Qualifications

• Comprehensive knowledge of health benefits policies and compliance.
• Strong analytical skills to evaluate complex information and apply policies and regulations accurately.
• Demonstrated ability to communicate effectively both orally and in writing.
• Strong organizational and time management abilities, including the capacity to set priorities, work independently, and meet objectives with minimal supervision.
• High School Graduate or equivalent.

Responsibilities

• Assist the Program Manager in the administration and development of policies for the health benefits program.
• 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.
• Collaborate with other Specialists in the Employee Services Unit to ensure consistent program administration.

Skills

Health benefits policies

Analytical skills

Communication skills

Organizational skills

Customer service skills

Education

High School Graduate or equivalent

Tools

Computer applications

Job description

Title: Senior State Health Benefits Plans Specialist #00047

State Role Title: Human Resource Analyst II

Hiring Range: $85,000.00 - $100,000.00

Pay Band: 5

Agency: Dept of Human Resource Mgt

Location: Main Street Center

Agency Website: www.dhrm.virginia.gov

Recruitment Type: General Public - G

Job Duties

The Employee and Retiree Services Unit within the Office of Health Benefits in the Virginia Department of Human Resource Management is seeking a highly competent and motivated person to fill the position of State Health Benefits Plans Specialist Senior. The Office of Health Benefits (OHB) delivers and administers health insurance and related benefit programs for Virginia’s agencies and political subdivisions, helping them attract and retain highly qualified employees. The Employee & Retiree Services unit ensures that benefit communications, policies, and procedures are clear, accurate, and aligned with all applicable laws, regulations, and contracts. We support agency Benefits Administrators in day to day program administration and serve as a central point of contact for employee and retiree appeals, questions, and concerns. This position will assist the Program Manager in the administration and development of policies for the health benefits program and work with the Program Manager in developing a relationship with plan administrators and monitoring plan performance. Additionally, this position will be responsible for providing guidance and advice to Benefits Administrators, employees and retirees on policies and procedures and handles the more complex inquiries, appeals and complaints pertaining to the State and Local Health Benefits programs. This position works with the Specialists in the Employee Services Unit, and provides guidance and instruction as appropriate.

Minimum Qualifications

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 to prepare correspondence and reports. Demonstrated ability to communicate effectively both orally and in writing. Strong organizational and time management abilities, including the capacity to set priorities, work independently, and meet objectives with minimal supervision. Demonstrated customer service skills. High School Graduate or equivalent.

Additional Considerations

Experience with medical claims; Background in utilization review; Experience, certification, or education in health benefits highly desirable; Experience in policy development.

All applicants are subject to a background investigation. The investigation may include: fingerprint checks (State Police, FBI); local agency checks; employment verification; verification of education (relevant to employment); credit checks; and other checks requested by the hiring authority.

"The Department of Human Resource Management is dedicated to recruiting, supporting, and maintaining a competent and diverse work force."

Equal Opportunity Employer

Department of Human Resource Management
600 East Main Street, 17th Floor
Richmond, Virginia 23219
[phone]

In support of the Commonwealth’s commitment to inclusion, we are encouraging individuals with disabilities to apply through the Commonwealth Alternative Hiring Process. To be considered for this opportunity, applicants will need to provide their AHP Letter (formerly COD) provided by the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Service-Connected Veterans are encouraged to answer Veteran status questions and submit their disability documentation, if applicable, to DARS/DBVI to get their AHP Letter. Requesting an AHP Letter can be found at AHP Letter or by calling DARS at 800-552-5019.

Note: Applicants who received a Certificate of Disability from DARS or DBVI dated between April 1, 2022- February 29, 2024, can still use that COD as applicable documentation for the Alternative Hiring Process.