Job description
GEHA (Government Employees Health Association, Inc., pronounced G.E.H.A.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. We celebrate diversity and are committed to creating an inclusive environment for all employees.
GEHA has one mission: To empower federal workers to be healthy and well.
Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, GEHA empowers health and wellness by meeting its members where they are, when they need care. We serve our members with products they value and a personalized customer experience, sustained by a nimble and efficient organization.
Provides technical oversight to Health and Business staff, responds to questions, complex service issues and workflow issues. Monitors and reports to management issues that impact the integrity of the networks including, provider and member data, service issues, system audits and internal operational issues. Assists Management with special projects, implementation and execution of new programs and processes. Analyzes department production reports, turnaround time and various department data. Works cross functionally with many areas throughout GEHA to coordinate and implement multi-departmental contract processes. Analyzes and monitors network turn-around time to ensure that team is meeting goals.
SKILLS
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Analyzes, reviews, tracks, prepares and facilitates Network data reports, files and summaries, including service issues, surveys, system audits and internal operational issues.
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Oversees leased networks, vendors, clients, members or provider’s service issues, workflow processes Manages provider contract terms and conditions. Serves as a liaison between vendors, networks, members, providers or clients and all other GEHA departments.
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Oversees the Connection Dental Network – Rewards Partners program.
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Assists with Network Policies and Procedures to ensure compliance of Department and Network contractual obligations are met.
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Supports projects related to Accreditation.
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Works collaboratively with other GEHA departments to assist with audit.
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Oversees all provider communications (website, email and other). Works collaboratively with other GEHA departments to ensure Network compliance of state regulatory and contractual requirements and client needs are met.
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Prepares and presents training curriculum, projects, programs and status updates in various meetings with all levels of management.
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Other duties as assigned.
REQUIREMENTS: Education and Experience
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Requires a bachelor’s degree (120 credit hours)
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Requires three years of analytic experience in a clinical, health insurance or health care setting
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Additional years of qualifying work experience may be considered in lieu of formal education
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Requires analytical skills to evaluate provider, member, vendor, client, and group and network data. Must be capable of making independent decisions
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Requires effective written and verbal communication skills to compose formal documents, present ideas and communicate with Dental Service Organizations, large groups, provider’s vendors, clients, members and all levels of GEHA management
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Requires proficiency of MS Word, Excel, Facets and Access applications
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Some travel may be required
PREFERRED:
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Salesforce Experience
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Strong Writing Skills
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Website Administration
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Dental Network Experience
** One position will report to Kristine Campbell and the other will report to Crystal Dercher **
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 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
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
Please note that the salary information is a general guideline only. GEHA 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 annual base salary range for this position is $60,393 - $84,608 USD.
GEHA 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. GEHA 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. Our diversity drives innovation deepens connections and strengthens our organization.
GEHA 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.
An Executive Order was released stating that federal contractors must require COVID-19 vaccinations for all US employees. As a company that works on federal contracts, we have a legal requirement to comply with the executive order, if it is enforced.
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