Vermont Healthcare Service Specialist III

We are the Department of Vermont Health Access (DVHA), specifically the Health Access Eligibility and Enrollment Unit (HAEEU). Our mission is to improve Vermonters’ health and well-being by providing access to high-quality, cost-effective health care. Our three priorities are advancing value-based payments, modernizing information-technology infrastructure, and operational performance improvement. We uphold three core values: Transparency, Integrity, and Service.

As part of these values, we are committed to supporting diversity, equity, inclusion, and accessibility. We actively celebrate differences in ability, racial identity, sexual orientation, ethnicity, age, and gender. Everyone is welcome and supported here.

Vermont is a “small but mighty” state, ranked among the top 10 to raise a family in 2022 and a nationwide leader in progressive social and educational policies. Located in Northern New England, we are 1.5 hours from Montreal and 3.5 hours from Boston, with beautiful Lake Champlain, the Green Mountains, and year-round outdoor activities.

About the role

This is a full-time, hybrid call-center position offering a Monday–Friday schedule and a supportive work environment. Duties are performed in a standard office setting; occasional travel may be required, for which private transportation must be available. Stressful interactions with upset or emotional clients may occur, and staff workload can be heavy. Work outside typical business hours may be expected, and incumbents might be required to appear in court representing the State of Vermont.

Responsibilities

• Engage in extensive customer interaction via phone to address complex inquiries regarding healthcare eligibility, enrollment, and premium issues.
• Collaborate with Health Care Services Specialists, Support Services Specialists, and other contractors to assess and correct errors on customer cases.
• Conduct investigations and research on healthcare cases, communicating findings by phone with professional partners such as Vermont Legal Aid and care providers.
• Complete all work within strict time frames while ensuring accuracy.
• Analyze and interpret legal rules and policies as they apply to each case.
• Assist in resolving system communication errors with Vermont Health Connect Partner systems based on research findings.
• Manage a diverse caseload that varies in complexity and volume throughout the year.
• Identify error trends that contribute to escalations and recommend improvements to information resources and business processes to minimize repetitive errors or misinformation, whether human or system-related.

Requirements

• Two (2) years of customer-service experience using computer programs such as database management, CRM (Customer Relationship Management) software, or Microsoft Office programs, or the ability to explain policies, procedures, rules, or regulations.
• OR six (6) months of work experience as a Vermont Healthcare Service Specialist I or II (VHSS I/II).

Preferred Qualifications

• Experience within a call-center environment.
• Experience with research and review of healthcare services or a similar field, and processing work within a caseload management system.
• Self-motivated team player.

Benefits

• 80% State-paid medical premium and a dental plan at no cost for employees and their families.
• Work/life balance: 12 paid holidays each year and a generous leave plan.
• State-paid Family and Medical Leave Insurance (FMLI).
• Two ways to save for retirement: a State-defined benefit pension plan and a deferred-compensation 457(b) plan.
• Tuition reimbursement.
• Flexible spending healthcare and childcare reimbursement accounts.
• Low-cost group life insurance.
• Incentive-based Wellness Program.
• Qualified employer for Public Service Student Loan Forgiveness Program.

Schedule

Monday–Friday, hybrid work environment. Upon hire, employees work with their supervisor to create a schedule that aligns with the business needs of the unit.

This position is a STATE PROMOTIONAL ONLY posting. Only current State of Vermont employees who have successfully completed an original probationary period OR non-State employees eligible for veteran’s preference are eligible to apply.