SENIOR DIRECTOR OF SELF-FUNDED HEALTH PLANS

Location: Oakland
Job ID: 34695
Job Posting

THIS JOB WAS RE-POSTED AND WILL BE OPEN UNTIL FILLED.

For UCOP internal applicants, please login to the internal candidate gateway at: Jobs at UCOP

UC OFFICE OF THE PRESIDENT

At the University of California (UC), your contributions make a difference. A world leader producing Nobel and Pulitzer prize recipients with over 150 years of groundbreaking research transforming the world. Choose a career where you can leverage your knowledge, skills and aspirations to inspire and support some of the greatest minds in the world, and those who will follow in their footsteps. Working at the University of California is being part of a unique institution, and a vibrant and diverse community. At the University of California, Office of the President, we propel our mission through impactful work locally, in government centers and systemwide. We are passionate people, serving the greater good.

The University of California, one of the largest and most acclaimed institutions of higher learning in the world, is dedicated to excellence in teaching, research and public service. The University of California Office of the President is the headquarters to the 10 campuses, six academic medical centers and three national laboratories and enrolls premier students from California, the nation and the world.

DEPARTMENT OVERVIEW

UC Health's self-funded health plans play a significant role in helping the University retain funds spent on health insurance premiums by both the employer (UC) and employees within its own system. In 2014, the University of California launched UC Care, a self- insured PPO health plan. The plan provides medical and pharmacy benefits to UC employees, non- Medicare retirees and their families. UC Health is responsible for the administration of the plan. Beginning in January 2017, UC Health is also responsible for two high deductible and three additional Medicare plans that are self-insured for employees. Total membership in all these plans is about 85,000. In 2020, the PPO plans spent only 5% of each premium dollar on administration compared with 15%-20% spent by commercial health plans. There is also a flex-funded HMO plan, UC Blue & Gold HMO, with an enrollment of 123,000 that has an ACO relationship with the UC medical centers. UC Health provides financial management, population health management and strategic thinking to the medical centers for this plan, in addition to co-administering the plan.

POSITION SUMMARY

The Senior Director of Self-Funded Plans reports to the Executive Director of Self- Funded Health Plans in UC Health at UC Office of the President (UCOP). Using a high degree of knowledge in the overall field, the position works collaboratively as part of a dynamic team, offering expertise, problem- solving, and strategy solutions. The Senior Director is responsible for the operations (administration, communication and financial) of the UC commercial PPO plans, including participation in developing a new, virtual first plan offering. This position is expected to determine objectives, direct programs, develop strategies and policies, manage human, financial, and physical resources and function with a high degree of autonomy. Under the direction of the Executive Director, the Senior Director will actively assess risks and establish systems and procedures to protect organizational assets. Continual evaluation of the plans is a critical factor for success. Decisions made by this position require consideration of a variety of factors, including an understanding of current business trends.

The Senior Director will work closely with the Deputy Administrator of Self-Funded Health Plans and Executive Director to advance the five year Health Plan Road Map that has been created in conjunction with UC Health leadership.

The position supervises a Program Manager who has responsibilities for the daily administrative management and vendor relations of the self- funded health insurance plans, which provide benefits to UC employee, non-Medicare retirees, graduate students and their families. The Senior Director has responsibility to achieve broad goals by establishing objectives, direct programs, develops strategies and policies, and manages human, financial and physical resources. The incumbent is expected to establish work plans and delegate assignments to subordinate managers. Reviews and approves recommendations for functional programs. Involved in developing, modifying and executing policies that affect immediate operations and have organization-wide effect. This position manages cross-functional and cross-organizational teams to develop and implement programs while ensuring quality deliverables and outcomes. Problems/issues addressed are of a diverse scope where management of issues or data requires in-depth evaluation of variable factors. The position requires collaboration with a diverse group of colleagues and business partners in a complex organizational structure.

Responsibilities

30%

Oversee the activities of the University's third party claims administrators (TPA) and other vendor partners for self-funded plans to ensure a high quality of claims administration; In collaboration with UC Health leadership, create and maintain a benefit structure that provides affordable, comprehensive coverage to UC employees and their dependents; assist leadership and Executive Director with strategic direction and growth of the self-funded health plan program.

15%

Lead regular status meetings with vendor partners, including consultant/ brokers, to ensure all ongoing issues and deliverables are handled and all staff meet expectations of their job functions. Oversee self-funded plan operational implementations as necessary; work with UC Legal to ensure contracts are executed and implemented according to University policy. Lead and participate in the development of a cross functional program operations manual.

15%

Working with Executive Director of Self-Funded Health Plans, coordinate management of external consultants to provide actuarial analysis and administrative guidance to the plans, and ensure consistency with higher education benchmarks and insurance industry standards as appropriate.

10%

Assign and supervise activities of self-funded health plan staff to ensure high levels of productivity and accuracy. Address staffing needs to ensure continuity of service levels.

10%

Collaborate on the development and execution of the marketing strategy and communications of the self-funded plans. Provide support activities relating to the population health group.

10%

In collaboration with leadership and Procurement, conduct RFPs for potential vendors, contract with health insurance carriers and administrators, and uphold contract terms over the life of the agreement. Administer vendor performance agreements and coordinate annual renewals.

10%

Interact with stakeholders and constituents to provide information to them about plan benefits, strategies and funding. Respond to member issues as they arise and ensure that they come to a successful conclusion.

Required Qualifications

• Requires a minimum of eight years' experience managing the implementation and administration of health benefit programs, preferably self-funded plans.
• Requires direct healthcare operations management expertise in self-funded healthcare products, including benefits, eligibility, enrollment, enrollment systems, call centers, premium billing, program/systems/product implementations and HIPAA.
• Solid experience implementing large-scale/complex/political change initiatives with demonstrated leadership in business planning, financial planning and analysis and program development required.
• Proven experience engaging and working in a team environment required.
• Excellent skills to work collaboratively and act persuasively in sensitive situations utilizing tact and diplomacy.
• Excellent interpersonal skills to effectively lead, motivate and influence others and develop and maintain high standards of customer service.
• Ability to supervise and motivate staff and team members to achieve unit and program objectives.
• Proven ability to maintain an organized approach, clarity of purpose, and goal orientation in a rapidly changing environment involving multiple stakeholders of various levels from throughout the organization. Strong action planning skills and ability to manage multiple priorities and deadlines.
• Excellent organizational skills with demonstrated ability to manage multiple projects and meet deadlines. Ability to lead and pursue objectives independently while exercising good judgment and exhibiting a considerable degree of creativity.
• Good working knowledge of Windows and the Microsoft Office Suite including word-processing, spreadsheet applications, and PowerPoint.
• Excellent time management and organizational skills.

Preferred Qualifications

• Proven experience in project management, development and facilitation of planning sessions with executives, physicians, directors/trustees, and management of consultants desired.
• Experience working in an academic institution desired.
• Experience working directly in or with health care institutions strongly preferred.
• Proven experience working in a rapidly changing environment; must be able to handle pressure and react positively to stressful situations.

Education

• Bachelor's degree in a health-related area and / or any combination of relevant education and experience which would demonstrate knowledge, skill, and ability to perform the essential duties and responsibilities.

SALARY AND BENEFITS

Salary: Commensurate with experience.

Benefits: For information on the comprehensive benefits package offered by the University visit: Benefits of Belonging

ADDITIONAL INFORMATION

HOW TO APPLY

Please be prepared to attach a cover letter and resume with your application.

APPLICATION REVIEW DATE

The position will be open until filled.

CONDITIONS OF EMPLOYMENT

Background Check Process: Successful completion of a background check is required for this critical position. Background check process at UCOP

Smoke Free Work Environment: The University of California, Office of the President, is smoke & tobacco-free as of January 1, 2014. UC Smoke & Tobacco Free Policy

August 2021 Update: The University of California has issued a policy requiring employees to be fully vaccinated against COVID -19 before physically accessing the University location or programs. Upon hire into a UCOP position, you will be provided detailed instructions on how to comply with this policy including access to the COVID vaccination at no cost. New hires to UCOP who work onsite or will come onsite for any activities at a UCOP or other UC location must comply with this policy within 8 weeks after their start date. The policy allows for employees to request approval for an exception or deferral. UC COVID-19 Vaccine Policy

EEO STATEMENT

The University of California, Office of the President, is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status. EEO/AA Employer UC Nondiscrimination Policy

The University of California, Office of the President, strives to make this job board accessible to any and all users. If you have comments regarding the accessibility of our website or need assistance completing the application process, please contact us at: Accessibility or email the Human Resource Department at: epost@ucop.edu

*LI-SG1



To apply, visit https://careerspub.universityofcalifornia.edu/psp/ucop/EMPLOYEE/HRMS/c/HRS_HRAM.HRS_APP_SCHJOB.GBL?Page=HRS_APP_JBPST&Action=U&FOCUS=Applicant&SiteId=19&JobOpeningId=34695&PostingSeq=1







Copyright 2022 Jobelephant.com Inc. All rights reserved.

Posted by the FREE value-added recruitment advertising agency

jeid-1e7b47f2296ff644b41c95b3e097a957

Return to Search Results