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PROGRAM ADMINISTRATOR

  • 509702
  • PHOENIX
  • DEPT OF INSURANCE AND FINANCIAL INSTITUTIONS
  • Full-time

DEPARTMENT OF INSURANCE AND FINANCIAL INSTITUTIONS

The Department of Insurance and Financial Institutions licenses, monitors, investigates, examines, and ensures the safety and soundness of, regulated entities. The Department also helps resolve consumer complaints against financial-services and insurance entities; takes action in response to violations of law; encourages competition, innovation, and economic development; collects taxes and assessments that support State government operations; combats auto theft and insurance fraud through public awareness campaigns, and funding for law enforcement and dedicated prosecutors.

Our mission is to help Arizonans receive the benefits and protections to which they are legally entitled by enforcing insurance and financial institution laws and by providing information and assistance and to combat vehicle theft.

PROGRAM ADMINISTRATOR

Job Location:

100 North 15th Avenue

Phoenix, Arizona 85007  

Posting Details:

Annual Salary Range: $70,000 - $78,000  

Grade: 25

This position will remain open until filled  

Job Summary:
                      ***This position serves as a manager (includes planning, directing subordinates, and interpreting policy)***                      

Under the direction of the Assistant Director of the Product Filing & Compliance Division, this position has day to day oversight of several programs within the Life & Health section of the Division, including: life and health product filing compliance; state/federal coordination of Qualified Health Plans; mental health parity compliance; managed care compliance; long term care rate review administration; and the NAIC Interstate Compact.

This position supervises the analysts who review life and health policy form, rate and advertising filings, as well as performing filing reviews, with emphasis on insurer rate filings. This position analyzes the competitiveness of Arizona’s individual and small group Arizona major medical health insurance markets, using a variety of data collection methods.

Market monitoring includes evaluating the number of carriers and plans available each plan year by county and range of premiums, service area expansions, network adequacy, provider timely pay compliance, and plan discontinuations and market exits.

Job Duties:
• Supervise: Hire, train, support, evaluate performance, create tools to facilitate uniform procedures for the review of life and health insurance filings. Integrate MHPAEA requirements into existing forms review and oversee analysis of filings to evaluate insurer compliance with Mental Health Parity Quantitative Treatment Limit (QTL) requirements. Supervise contract consultants, including billings, and the Managed Care Compliance Administrator position. This involves public relations, complex data and regulatory analysis and enforcement activity which requires additional oversight and engagement with external customers, including attorneys, executives and policy makers

Filings: Review and consult on complex, unique life/health filings; review and oversee the review of ACA rate filings, including coordinating with consulting actuaries; moderate/escalate filer disputes and compliance issues; interpret regulatory requirements; develop and maintain instructions and resources for filer and analysts; monitor state and federal laws/regulations and incorporate changes into division operations; update SERFF requirements and maintain organizational systems to support SERFF data integrity; ensure up to date instructions and guidance are available to insurers for the completion of required Mental Health Parity data submissions; provide reports on Mental Health Parity QTL filing analysis to the Mental Health Parity Administrative Services Officer; make recommendations for process improvement

Data analysis: Annually analyze the health of Arizona’s major medical health insurance market; annually complete data validity and substantive reviews of ACA plan templates using CMS Tools, including MHPAEA QTL compliance; collect and analyze data, and create reports on a variety of topics including Mental Health Parity; monitor market and rate trends, advise leadership of concerns; research and draft department policies; provide input on legislation, rules, bulletins; extract data from ACA filings using specialized tools; use data to assist in responding to media, industry and advocacy group inquiries; develop tools to collate and analyze data; produce summaries of health insurance market analysis for internal analysis and external publication. Make recommendations for process improvement

Compliance: Analyze violations of state and federal insurance requirements; make well-reasoned, supported recommendations for enforcement actions to the assistant director; testify at administrative hearings if needed; coordinate with the Mental Health Parity Administrative Services Officer on the evaluation of and reaction to insurer compliance with federal and state requirements pertaining to Mental Health Parity; submit information to federal agencies as required, including data on risk adjustment, market participation, QHP certification, EHB benchmark plans; coordinate regulatory efforts with other division personnel, insurers, attorneys, state and federal agencies, and NAIC

• Other duties as assigned as related to the position

Knowledge, Skills & Abilities (KSAs): Knowledge:

• Sophisticated insurance principles, terms and concepts; insurance health insurance rate and rate development; insurer and insurer support organization operations and industry practices, including managed care and network plans

• Federal Qualified Health Plan certification requirements and procedures and federal Affordable Care Act regulations, guidance and procedures related to the individual and small group markets

• State laws/regulations related to major medical health insurance, and other types of personal and commercial health and life insurance, such as long term care, limited benefit, dental, Medicare supplement, life, annuity, and life settlement contracts

• Computer software including Excel, Google Suite, presentation software, data collection and analysis software, and NAIC data sources and systems (e.g., SERFF, SBS, Isite)

• Research, data compilation and analysis, database queries, writing reports, writing and administering surveys and other data collection tools and analyzing and reporting results

• Personnel regulations and policies; principles of supervision and management, managerial communication, organization dynamics, systems development, negotiation techniques, strategic planning, process improvement and Arizona Management System techniques

• Laws and rules related to Mental Health Parity Addiction and Equity Act

• Insurance contract terms and structure and insurer operations

• Legislative and rulemaking processes

Skills:

• Collecting, organizing, synthesizing and analyzing complex data into well-supported reports, pivot tables, spreadsheets, etc

• Coordinating and communicating with multiple internal and external audiences with differing knowledge levels

• Preparing and presenting technical information to individuals and groups in verbal and written forms

• Researching, interpreting, summarizing and applying state and federal law, regulations and guidance

• Regulatory analysis and compliance coordination

• Exceptional organization and time management

• Coaching, team building and staff development

• Exceptional written and verbal communication

Ability:

• Establish and maintain effective, diplomatic, professional verbal and written communications and relationships with internal and external audiences of varying insurance knowledge

• Analyze complex data and use Excel and other software to present findings and recommend action and follow up analysis

• Evaluate difficult, conflicting issues and adopt an effective course of action

• Organize and prioritize complex, competing projects and resources

• Effectively supervise and motivate subordinate and technical staff

• Work autonomously

Selective Preference(s):
•Healthcare Compliance Professional (HCP) Designation desired
 
Pre-Employment Requirements: • Employees who drive on state business are subject to driver license record checks, required to maintain acceptable driving records and complete any required driver training (see Arizona Administrative Code R2-10-207.11)

• Requires possession of and ability to retain a current, valid state-issued driver license appropriate to the assignment

Benefits: The State of Arizona offers a comprehensive benefits package to include:

• Optional employee benefits include short-term disability insurance, deferred compensation plans, and supplemental life insurance

• Life insurance and long-term disability insurance

• Vacation plus 10 paid holidays per year

• Health and dental insurance

• Retirement plan

• Sick leave

For a complete list of benefits provided by The State of Arizona, please visit our benefits page

Retirement: • Positions in this classification participate in the Arizona State Retirement System (ASRS)

• Please note that enrollment eligibility will become effective after 27 weeks of employment

Contact Us: • If you have any questions please feel free to contact Shawn McConnell at shawn.mcconnell@azdoa.gov

ARIZONA MANAGEMENT SYSTEM (AMS)

All Arizona state employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government whereby every employee reflects on performance, reduces waste, and commits to continuous improvement with sustainable progress.  Through AMS, every state employee seeks to understand customer needs, identify problems, improve processes, and measure results.  
State employees are highly engaged, collaborative and embrace a culture of public service.

The State of Arizona is an Equal Employment Opportunity Employer.