Operations Trainer

🕒 5 days ago

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Evry Health

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2017

⚕️ Healthcare Insurance

🤝 B2B

🧘 Wellness

Healthcare Insurance • B2B • Wellness

Evry Health is a modern, mobile-first health insurance company that provides fully insured employer health plans and personalized care teams. Built for midsize and larger employers (primarily in Texas), Evry offers no-copay, no-deductible plans, 24/7 virtual care, integrated wellness programs, and individualized support from nurses, nutritionists, and doctors to simplify costs and improve employee health. The company emphasizes a human, member-focused approach and digital tools (iOS/Android app) to deliver care and benefits.

📋 Description

• Deliver engaging, interactive training sessions via Teams platform for new hires and tenured staff covering product knowledge, soft skills, and systems navigation. • Lead structured onboarding programs covering Evry Health’s products, systems, workflows, policies, and member-centric service standards. • Design and facilitate live role-play scenarios that mirror real customer interactions, claims inquiries, and escalation situations. • Combine synchronous instructor-led sessions with asynchronous e-learning modules, job aids, and recorded content. • Administer knowledge checks, quizzes, and skills assessments to confirm learner readiness before live deployment. • Monitor staff performance; identify training gaps and deploy targeted interventions to address deficiencies quickly. • Collaborate with Operations leadership to craft clear, timely change communications that prepare agents for upcoming system or workflow transitions. • Train staff on end-to-end claims lifecycle, adjudication, issue identification and remediation, including testing outcomes, denial, adjustment, and dispute procedures. • Deliver training on Texas Insurance Code Chapter 1467, prompt-pay requirements, IDR processes, and CMS guidelines. • Provide foundational instruction on ICD-10, CPT, HCPCS, and modifier usage as it relates to claims review and provider disputes. • Train agents on Evry Health’s call-handling protocols and quality expectations. • Coach staff on professional, empathetic communication. • Reinforce 1-business-day (member) and 2-business-day (provider) correspondence turnaround standards and documentation requirements. • Build staff confidence in identifying, documenting, and escalating complex or sensitive cases to supervisory and clinical teams. • Align training content with QA audit rubrics covering call quality, case accuracy, and documentation standards. • Develop and maintain SOPs, job aids, desk-top procedures, e-learning modules, and quick-reference guides for all operational workflows. • Build comprehensive knowledge assessments with scoring rubrics aligned to benefit program content and operational standards. • Promptly revise training materials in response to regulatory changes, system updates, or operational policy revisions. • Upload, organize, and track training completion records. Generate training completion reports, assessment score summaries, and gap-analysis data for Operations leadership.

🎯 Requirements

• Bachelor’s degree in Business, Healthcare Administration, Education, Communication, or a related field; or equivalent work experience. • 3–5 years of experience in health plan operations (claims and/or customer service); minimum 2-4 years in a training, coaching, or instructional role. Strong preference for background in operations and contact centers. • Working knowledge of claims adjudication, appeals/grievances, EOBs, ICD-10/CPT coding. Texas Insurance Code knowledge is a plus. • Demonstrated expertise in contact-center operations including call quality, and member/provider communication standards (both verbal and written). • Proven ability to engage and manage remote audiences via Zoom, Microsoft Teams, or equivalent video-conferencing platforms. • Experience with Salesforce, Vonage, and/or comparable CRM, telephony, and health plan platforms. • Exceptional written and verbal communication skills; ability to translate complex regulatory and clinical content into plain-language training. • Strong project-management skills with the ability to manage multiple training cohorts, deadlines, and content-revision cycles simultaneously. • Certification in instructional design, adult learning (CPLP, ATD), or a related credential (preferred). • Experience with e-learning authoring tools such as Articulate 360, Rise, or Adobe Captivate (preferred). • Familiarity with CMS Star Ratings, NCQA, or URAC accreditation standards (preferred).

🏖️ Benefits

• Evry Health-issued laptop, headset, and collaboration tools provided