FHPS SME II - Claims
Elevance Health

Job Info

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FHPS SME II - Claims

Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of our Roanoke, VA Elevance Health PulsePoint location.

At Federal Health Products and Services - FHPS, a proud member of the Elevance Health, Inc. family of companies, it is a powerful combination, and the foundation upon which we are creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

The FHPS SME II is responsible for providing Subject Matter Expertise for a variety of Federal Health Products & Services (FHPS) Customer Care training programs and content documentation such as scripts and reference materials.

How you will make an impact:

• Researches, reviews, extrapolates, revises, and validates training materials and documentation to ensure they are accurate and complete according to Federal Employees Program (FEP) policies, procedures and related call center technologies.
• Assists Training Quality and Content team with analyzing, assessing needs, and identifying root causes.
• Supports development and maintenance of training materials and documentation.
• Keeps knowledge and expertise current by reviewing FHPS policies, procedures, publications, program materials, etc.
• Researches newly deployed and/or pending FEP Regulations (for example, researches Change Requests and Joint Signature Memorandums and then provides impact summaries to the impacted stakeholders).
• Designs new and enhanced training programs and documentation based on needs.
• Assesses training outcomes and determines if further training or documentation is needed.
• Supports delivery and/or delivers train-the-trainer sessions.
• Makes recommendations to management on training and content improvements or enhancements.
• As needed, participates in meetings with primary contractor and the FEP Director's Office.
• Manages day-to-day interactions and relationships.
• Acts as a liaison with primary contractor associates.
• May assist with process re-engineering and with project work.
• Is a high level FHPS expert in 2-3 or more lines of business.
• Travels to worksite and other locations, as necessary.

Minimum Requirements:

• Requires a bachelor's degree and a minimum of 6 years of FHPS experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Prior experience working in with FHPS claims processing highly preferred
• Experience providing training, coaching and feedback on work deliverables preferred.
• Experience working with Streamline and FEP Direct systems highly preferred
• Effective oral and written communication skills is strongly preferred.

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed.

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