Associate Director, Health Plans

Overview

The University of Southern California (USC) Keck School of Medicine/Office of SVP for Health Affairs is seeking an Associate Director to join its Health Plans team!

The Associate Director, Health Plans manages major components of the University's health and wellness plans and programs. The Associate Director will be responsible for the day-to-day operations alongside the Director of Health Plans Administration of USC's self-funded and fully-insured health plans for faculty, staff and retirees. The position reports to the AVP of Health Plans.

Main responsibilities will include plan administration, oversight of operations and strategy of wellness and medical management programs, manage health plan member services and in collaboration with senior leaders monitor plan expenses.

• Plans and develops health and wellness program objectives and content. Researches and identifies trends and needs and establishes program directions accordingly. Assesses quality of program operations. Modifies existing program services or creates new program offerings to maintain or enhance program standing. Links program with other relevant departments on or off campus as necessary.
• Serves as a key resource for self-funded health plans and wellness program information. Resolves problems or questions referred by program staff, senior university administrators, or external vendors.
• Develops and recommends program operating and administrative policies. Manages the dissemination, interpretation and application of plan and program policies and recommends approval of exceptions.
• Develops services that achieve a high level of customer satisfaction with emphasis on customer service, highest standards of quality and innovation. Manages and resolves human resource and member claims and plan related issues.
• Plans and conducts quality assurance reviews and recommends changes as appropriate. Develops and maintains automated or manual systems and procedures to facilitate program operations.
• Directs the budget and resource allocations related to health and wellness programs. Manages the financial performance and identifies and implements strategies to reduce costs and improve quality of care and services.
• Develops strategies for communicating and promoting programs to include market research and development, communications materials, and events planning for open enrollment and year-round employee reminders and engagement.
• Performs other related duties as assigned or requested. The university reserves the right to add or change duties at any time.

Candidates for the position of Associate Director, Health Plans must meet the following minimum qualifications:

• Bachelor's degree
• 5-7 years of directly related professional and supervisory experience in health insurance programs
• Minimum Education:
  
  Bachelor's degree
• Minimum Experience:
  
  3 years
• Minimum Field of Expertise:
  Directly related professional and supervisory experience in area of program specialization

The ideal candidate for the position of Associate Director, Health Plans has the following preferred qualifications:

• Master’s in Business Administration (MBA) or Health Administration (MHA) or related.
• Knowledge and experience in managed health care. General understanding including but not limited to: claims processing functionality, benefit coverage, provider network, standard billing requirements; and HIPAA regulations.
• Knowledge and experience in administering an ERISA governed health plan.
• Familiarity with finance management in healthcare, insurance, and pharmaceutical industries a plus.
• Good organizational and project management skills, demonstrated strong interpersonal communication skills, both written and verbal and detailed oriented.
• Proficient experience using Microsoft Office, including advanced knowledge in Microsoft Excel, Access, PowerPoint, Word and Outlook.

The University Health Plans department is tasked to oversee all medical, dental, vision and prescription care benefits for the university's faculty, staff, and their dependents (nearly 19,000 USC benefits eligible employees / 30,000 member lives). Employees may choose from six health insurance coverages options that include PPO, EPO and HMO plan types. Employee contributions vary depending on 5 tiers of salary groupings and number of eligible family members enrolled.

The department plays a key role in supporting USC through key initiatives through health plan management, plan design, benefit planning, employee contribution pricing, financing and budgeting, and member services, all while balancing central administration's needs for fiscal discipline. The Health Plans department goals include member education about plan design and features, improving member satisfaction, partnering with Keck providers and plan administrators to establish innovative models to improve quality of care and outcomes, engaging in responsible cost containment efforts, continuous improvement of self-funded medical plan…