Director of Insurance

Grade: E

Department: Human Resources

Prepared Date: April 6, 2020

Revised By: Jeff Howard

Approved By: Dr. T. Lamar Goree

Revised Date: April 7, 2020

SUMMARY

Responsible for strategic planning, negotiating, coordinating, directing and administrating district group hospitalization, life, dental, disability, accident, cancer, universal life, heart attack/stroke, TSA’s and Section 125 for active employees and retirees.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Essential duties and responsibilities include the following. Other duties may be assigned.

Manages insurance plans with various funding arrangements, including fully insured, self-funded and modified premium plans.
Manages all aspects of the self-funded health plan, including analysis of premiums and reserves, claims administration, development and implementation of medical management strategies, and contract negotiations.
Manages Retiree Drug Subsidy Plan (RDS).
Analyzes and identifies premium structure and/or plan benefit design changes for the financial health of the group insurance program.
Keeps abreast of group insurance industry practices, trends, cost-containment measures and new products.
Manages various aspects of Medicare including Medicare Secondary Payment (MSP), grievances, etc.
Coordinates request for proposal process (RFP) for group insurance programs.
Coordinates group insurance reporting.
Coordinates and/or prepares all reports, including tax reports, relating to group insurance reporting.
Develops and implements proactive approaches to efficient utilization of group insurance program resources.
Continuously monitors and provides routine periodic analysis and reporting of group insurance matters.
Releases information, when authorized, to various individuals and agencies concerning costs of various insurance programs in the school district.
Assists in the equitable solution of complaints, concerns, and problems in the area of responsibility.
Coordinates and provides information to various employee and retiree organizations, public boards and the public.
Make contacts with third party administrators for group insurance program, staff, Employee Benefits Committee, insurance agents, area health care providers, and other outside parties regarding group insurance.
Assists in managing OPEB Trust.
Neat well-groomed appropriately dressed appearance.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE

Ability equal to that resulting from satisfactory completion of courses required for graduation from an accredited college or university with a Bachelor’s degree in a business related field and/or a Master’s degree. Capability equivalent to that normally achieved through six to ten years of progressive professional experience.

PERSONAL CHARACTERISTICS

Ability to plan, organize and supervise the work of assigned personnel. Ability to work tactfully and harmoniously with schools, staff, agencies, employees and/or the public. Physical stamina and emotional stability to work effectively under pressure and to keep all aspects of the job under control. Ability to hold records, reports, and conversations in confidence.

LANGUAGE SKILLS

Ability to read, analyze, and interpret government regulations and the like. Ability to write reports, memos, and procedure manuals. Ability to effectively present information and respond to questions from staff, employees, retirees, school board, news media, and public groups.

REASONING ABILITY

Ability to define problems, collects data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit. The employee frequently is required to talk or hear. The employee is occasionally required to use hands to handle controls.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually quiet.

PROFESSIONAL CONDUCT

Employee acknowledges that he/she is required to maintain a high standard of professional conduct. Breach of said professional conduct includes but is not limited to: neglect of duty, dishonesty, engagement in acts that are contrary to CPSB policy, unlawful activities, or any other conduct which is seriously prejudicial to the school system.