DIRECTOR OF MUNICIPAL HEALTH PLAN 0944

DISTINGUISHING FEATURES OF THE CLASS

An employee in this class coordinates with the Employee Medical Health Plan Committee and the County Executive’s Office to create and maintain a high-performing and cost effective benefit program with an engaged and informed plan membership, and to set and execute a long-term strategy for the Plan. Supervision is exercised over the Employee Health Plan Administrator and other subordinate staff. The employee will be responsible for measuring and monitoring overall plan effectiveness, including member tools, to establish and promote a consistent healthcare experience with improved patient outcomes and financial efficiencies. While work is performed under the general direction of the County Personnel Officer, the incumbent will be required to report to the County Executive’s staff as needed, and may take direction from the EMHP Committee Co-Chairs. This employee works with a high level of independence. Does related work as required.

TYPICAL WORK ACTIVITIES

Coordinates all aspects of Employee Medical Health Plan (EMHP) focusing on plan management, vendor performance, claims resolution, and financial administration, planning and reporting;

Supervises and directs all EMHP staff including, Plan Administrator, Finance and the Employee Benefits Unit and any other staff as directed;

Reviews policies, procedures and administrative practices, and makes recommendations for modifications and improvements;

Consults with legal counsel as appropriate, or as directed by the Co-Chairs, on compliance and legislative matters;

Leads special projects, engagement of new vendors and implementation of new programs or plan design modifications, providing conformance with administrative and legislative requirements;

Identifies operational deficiencies and develops effective solutions;

Oversees the administrative performance of EMHP which includes assuring quality service standards and performance guarantees of each vendor;

Reviews the plan’s financial accounting, ongoing monitoring and budget reporting;

Assists with ad hoc projects under supervision of the County Executive’s Office, Co-Chairs and any other County Departments, as requested.

Investigates and researches questionable data and takes corrective action when necessary to resolve benefits inquiries and problems;

Serves as primary contact with Medical/Hospital vendor’s in-house liaison, will negotiate claims as needed and do all required outreach;

Performs and/or directs claims analysis and creates reports and dashboards as requested.

FULL PERFORMANCE KNOWLEDGES, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS

Thorough knowledge of the principles, practices and techniques of administering benefit programs; thorough knowledge of recent developments, current literature and sources of information in the field of employee health plans; thorough knowledge of financial and budgeting procedures; ability to understand County goals and recognize new approaches, policies and procedures to maintain continual improvement in EMHP’s objectives and long term strategy; ability to analyze facts and to exercise sound judgment in arriving at solutions to organizational problems and appeals; ability to establish and maintain effective working relationships with benefit providers; ability to prepare clear, accurate and comprehensive reports; ability to express oneself clearly and concisely, both orally and in writing; ability to plan, evaluate, and direct the activities of staff in a manner conducive to full performance and high morale; strong strategic, data-driven, and forward-thinking behavior for tactical and operational issues; physical condition commensurate with the demands of the position.

MINIMUM QUALIFICATIONS

OPEN-COMPETITIVE

Graduation from a college with federally-authorized accreditation or registration by NY State with a Bachelor's Degree in Business Administration, Finance, Accounting, or a related field, plus five (5) years of public or private sector management-level experience in the administration of a health benefits program, which includes at least two (2) years of high level analysis of major medical and hospitalization health benefits and claims analysis and reporting.

SUFFOLK COUNTY

Competitive

June 22, 2020