Self-Funded Health Plan Operations Senior Director
University of California Office of the President
Requisition Number: 20190351
Appointment Type: Staff - Career
Personnel Program: MSP
Work Hours: Mon-Fri, 8:00 AM -5:00 PM
Percentage of Time: 100
Organizational Area: Health Sciences and Services
Location: Oakland, CA
Posting Salary: Salary commensurate with experience.
Position Summary: The Health Plan Operations Senior Director reports to the Executive Director of Self-Funded Health Plans in UC Health in the 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 Health Plan Operations Senior Director is responsible for the operations (administration, communication and financial) of the UC Blue & Gold HMO and self-funded Medicare PPO Plans. 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 Health Plan Operations 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 and a sensitivity to the needs and desires of critical stakeholders.
Special Conditions of Employment: Travel
Other Special Conditions of Employment: Successful completion of a background check is required for appointment to this critical position.
Job Close Date:
Ongoing strategic design, administration and evaluation of the UC Blue & Gold HMO and self-funded Medicare PPO plans. Includes design, development and setting the direction of system-wide benefit program management and controls.
Job Requirements Bachelor's degree in Business Administration, Public Health Administration, or an allied field OR any combination of education and experience.
A minimum of eight to ten years of experience managing the implementation and administration of health benefit programs, preferably self-funded plans.
Solid experience implementing large-scale/complex/political change initiatives with demonstrated leadership in business planning, financial planning and analysis and program development.
Proven experience engaging and working in a team environment.
Ability to gain cooperation and support through effective use of influence and persuasion.
The ability to effectively oversee multiple projects simultaneously as well as manage large and diverse teams to deliver results within specified time frames.
Ability to supervise and motivate staff and team members to achieve unit and program objectives.
Proven knowledge of principles and procedures of fully-insured and self-funded health plan administration, including current literature, trends, and developments in the field of benefit program administration.
Ability to quickly learn university policies, procedures, practices, objectives and structure applicable to employee benefits.
Proven ability to use original thinking and independent judgment to develop solutions reflecting the legal, policy, and operational needs of the organization.
Possesses effective operational thinking and expertise with the ability to analyze and understand healthcare operations quickly to become a trusted advisor or demonstrate in depth knowledge of healthcare operations based on past experience.
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.
Proven ability to establish and maintain trust, confidence, and effective working relationships with colleagues and individuals of diverse occupational and social backgrounds.
Strong political acumen to intricate situations occurring in a complex, decentralized organizational structure; guide and negotiate complex issues through a hierarchical, bureaucratic organization to achieve resolution.
Proven experience working in a rapidly changing environment; must be able to handle pressure and react positively to stressful situations.
Demonstrated experience working collaboratively and influencing across a matrix environment.
Must have strong self-initiative and be able to prioritize and complete multiple projects on tight time frames.
Advanced knowledge of Windows and the Microsoft Office Suite including word-processing, spreadsheet applications, project management and database programs. Excellent time management and organizational skills.
Demonstrated customer service/member experience focus in all decisions and actions.
Knowledge of principles and practices required to develop, implement, and evaluate health and welfare benefit programs, legal regulations applicable to employee health insurance programs (HIPAA, PPACA, CMS, etc.).
Master's degree in Business Administration, Public Health Administration or an allied field.
Experience working in an academic institution.
Experience working directly in or with health care institutions strongly preferred.
Experience with marketing, branding and communications.
Direct healthcare operations management expertise in self-funded healthcare products, benefits, eligibility, enrollment, enrollment systems, call centers, Electronic Data Interface (EDI), premium billing, program/systems/product implementations and HIPAA.
Proven experience in project management, development and facilitation of planning sessions with key stakeholders including, executives, physicians, faculty, medical center managed care directors, population health leaders and consultants strongly preferred.
About us 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 corporate headquarters to the ten campuses, five medical centers and three Department of Energy National Labs and enrolls premier students from California, the nation and the world.
The University of California is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age or protected veteran status.