THE COUNTY OF RIVERSIDE HUMAN RESOURCES DEPARTMENT IS CURRENTLY RECRUITING FOR AN EXCLUSIVE CARE PLAN ADMINISTRATOR
TO SUPPORT THE COUNTY'S HEALTH INSURANCE PLAN
SALARY RANGE: $77,125.15 - $124,265.44 Annually
The County of Riverside Human Resources Department has an exciting job opportunity for an Exclusive Care Plan Administrator in Riverside. The Exclusive Care Plan Administrator will play an important role in the administration and operation of the self-funded and self-administered Exclusive Care Health Insurance Plan. Under the direction of the Exclusive Care Plan Division Manager, the incumbent will engage in comprehensive plan management, develop claims and medical management systems, prepare annual cost and revenue projections, and execute research into cost efficiency and program plan enhancements. Additionally, the Exclusive Care Plan Administrator will be tasked with compiling and analyzing plan expenses, preparing health benefit plan materials, and reviewing current and proposed legislation related to health plan administration.
Competitive candidates will have experience in a comparable self-funded managed care setting, with extensive experience in the areas of insurance benefit administration, claims administration and risk management. Additionally, the Exclusive Care Plan Administrator will possess a bachelor's degree or higher in health care administration or a closely related field. Candidates in possession of a Certified Employee Benefit Specialist (CEBS) or Group Benefits Associate (GBA) certification, and those with experience utilizing HealthTrio are highly desired. The selected candidate will possess significant knowledge of Federal and State laws, procedures, and regulations affecting all aspects of health care insurance plans and administration.
In addition to an exciting and challenging career opportunity, the County of Riverside offers a competitive salary, outstanding benefits package, and actively promotes a healthy work/life balance. Benefits include: more than 5 weeks of paid annual leave, a CalPERS defined benefit retirement plan, medical flex benefit of $823 monthly, paid vision, long-term disability, life insurance, deferred compensation (401a) contributions, and 12 paid holidays a year.
ABOUT THE COUNTY OF RIVERSIDE
Riverside County offers diversity that few locations can match. With a variety of job opportunities with the County, there are as many places to take your career as there are stars in our sky. But there is more than a great vocation to draw you here: with affordable housing, a thriving, diverse, and progressive community, excellent higher education, and the hidden gem of the Joshua Tree National Park, the opportunities for your life here are equally exciting. Come work in the heart of inland California, and see how great the view is when opportunity is on the horizon.
To find out more about the County of Riverside, please clickhere.
ABOUT THE DEPARTMENT
The County of Riverside Human Resources Department employs over 340 regular employees, and provides centralized services to approximately 22,000 employees across more than 40 departments within the County. These services include recruiting, employee relations, benefits administration, classification and compensation services, workers' compensation, risk management, temporary assignment program services, healthcare services, training, educational support, leadership and organizational development, and health and wellness programs.
The Human Resources Department seeks and develops talented professionals that fit a highly engaged and collaborative culture.
More information about the Human Resources Department can be found here.
ABOUT THE COUNTY OF RIVERSIDE EXCLUSIVE CARE HEALTH INSURANCE PLAN
The Human Resources Department also administers the County's own Exclusive Care Health Insurance Plan to provide low-cost preventive health insurance to County of Riverside employees, their qualified dependents, retirees, and qualified contracted employer groups. Exclusive Care provides innovative and comprehensive health care services through its own health clinic and pharmacy, as well as a network of participating hospitals, medical groups, and physicians throughout the County of Riverside through the Exclusive Care Provider Organization (EPO). Additionally, Exclusive Care establishes services with out-of-area providers as needed in order to provide the highest level of quality care to members. The plan benefits include extensive coverage to meet employee health care needs including, but not limited to, preventative care, specialty services, hospitalizations, and prescription drugs in order to provide the best services possible for very little cost and co-payment for its members.
For more information about the Exclusive Care Health Insurance Plan please click here.
EXAMPLES OF ESSENTIAL DUTIES:
• Direct, plan, administer, coordinate, and evaluate major components of the Exclusive Care Plan including premium collection, claims management, medical provider administration, vendor coordination, project management, and approving reports and statistics of actual and projected costs, revenues and resources.
• Analyze and interpret laws, ordinances, and regulations; meet with County management officials, employees, insurance carriers, and clients to obtain and/or disseminate information relating to the Exclusive Care Plan.
• Review current and proposed employee health insurance legislation and County resolutions and prepare written analyses and recommendations.
• Analyze data concerning plan expenses and resources for the purpose of determining necessary actions to reduce the cost to the County and enhance the Exclusive Care Plan.
• Analyze Exclusive Care Plan budgetary data and compile fiscal reports for use by Human Resources management.
• Direct the preparation of, or prepare, reports, studies, and educational materials relating to Exclusive Care health insurance benefits.
• Organize and oversee Exclusive Care employee benefit fairs and outreach events to promote the Exclusive Care Plan to County employees.
• Facilitate and participate in project management teams to research, investigate, and propose cost-effective means of enhancing the Exclusive Care Plan's service, effectiveness, and efficiency in administration and claims management.
• Approach and persuade potential private and public customers to offer the Exclusive Care Plan to their employees.
• Supervise and evaluate assigned staff.
Education: Graduation from an accredited college or university with a Bachelor's degree in health care administration, business, public administration, or a closely related field to the assignment. (Additional qualifying experience may be substituted for up to two years of the required education on the basis of one year of experience equaling 30 semester or 45 quarter units of education.)
Experience: Four years of progressively responsible administrative and supervisory experience in health insurance benefits, claims administration, and/or adjudication.
Knowledge of: The principles, methods, standards, and limitations in organizing and administering a comprehensive health insurance plan; federal and state laws relating to health insurance provisions; computer software systems designed to manage plan data and functions; principles of supervision including training, directing, and evaluating subordinates.
Ability to: Understand and interpret laws, rules, ordinances, and regulations pertaining to employee health insurance; effectively develop, introduce, and implement policies, procedures, and program design to provide service, manage claims and control costs; analyze complex issues and prescribe effective interventions in a timely fashion; communicate effectively orally and in writing with County personnel and outside individuals and agencies; train and supervise others; foster and maintain positive, harmonious working relationships with employees, officials, and the public.
INTERESTED APPLICANTS MAY APPLY FOR THIS POSITION USING THE COUNTY'S
The application deadline for this position is August 15, 2017, by 11:59 p.m. (PST), however postings may close at any time. Emailed or faxed resumes will not be accepted. All applicants must include a detailed resume/application indicating relevant health administration experience and education.
For questions regarding this recruitment, please contact Julia Luna at (951) 955-4957 or email@example.com.
About County of Riverside Human Resources Department
In the County of Riverside, the future is bright. With a variety of job opportunities with the County, there are as many places to take your career as there are stars in our sky. But there is more than a great vocation to draw you here: with affordable housing, a thriving, diverse, and progressive community, excellent higher education, and the hidden gem of the Joshua Tree National Park, the oppor...tunities for your life here are equally exciting. Come work in the heart of inland California, and see how great the view is when opportunity is on the horizon.