Sr Clinical Operations Specialist

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.

SKILLS

Summary

• 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

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.

Work-at-home requirements

• 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 30×5 (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

How we value you

• 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

While this is a remote opportunity, at this time G.E.H.A does not hire employees from U.S. territories or the following states: Alaska, Hawaii, California, Washington, Oregon, Colorado, Wyoming, Montana, New York, Connecticut, Vermont, Pennsylvania, Maine.

Please note that the salary information is a general guideline only. G.E.H.A considers factors such as (but not limited to) scope and responsibilities of the position, candidate’s work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.

The target hiring range for this position is $57,733 – $73,036 USD. At G.E.H.A, the current maximum salary for this role is $81,383 USD. While initial compensation may vary based on experience and qualifications, there is a path to work toward this top rate through performance and continued growth within the organization.

G.E.H.A is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. G.E.H.A will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees.

G.E.H.A is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.