STATE HEALTH BENEFITS PLANS SPECIALIST 27451

1/16/90 B

This is the first class in the Health Benefits Plans series which administers state and local government health benefits, flexible benefits and cost containment plans for state employees, retirees and their dependents; and for local government, local officers and school board employees, retirees and their dependents. This class assists in training benefit administrators, develops and reviews written materials for the plans, coordinates open enrollment activities, and researches and investigates complaints.

Complexity of Work: This class performs duties of moderate difficulty which include coordinating open enrollment activities; researching and drafting benefits policies, brochures, memos and articles for review; coordinating program activities with third party plan administrators, the Department of Accounts, other central agencies, and agency benefits administrators; overseeing printing and distribution of materials to administrators; providing technical assistance and training for benefits administrators; organizing briefings of supervisors, employees and retirees; investigating denial of benefits claims and slow response to claims; responding to "Hot Line" queries by benefits administrators; and assisting in the development of policies and procedures.

Supervision Given: Supervision is typically not a factor.

Supervision Received: Receives general supervision from the State Health Benefit Plans Administrator.

Scope: This class develops, coordinates and communicates program information which affects operational and administrative activities internal and external to the agency.

Impact of Actions: The performance and decisions of positions in this class can have a moderate impact on the agency's financial and employee relations posture because decisions and materials affect each state agency and participating local government agencies' health benefits, flexible benefits and cost containment plans.

Personal Contacts: This class has frequent internal contacts with benefits administrators in state agencies and in participating local agencies and with their employees, dependents and retirees. It has frequent external contacts with third party plan administrators and occasional external contact with vendors and the public.

Knowledge: Working knowledge of health benefits claims systems and of program regulations, administrative policies and procedures.

Skills: None identified for this class.

Abilities: Demonstrated ability to interpret regulations and policies and to communicate with diverse individuals.

QUALIFICATIONS GUIDE*

Licenses or Certification: None.

Education or Training: Graduation from high school with additional course work in personnel, public or business administration and training in health care administration.

Level and Type of Experience: Some experience in health care administration or delivery.

An equivalent combination of training and experience indicating possession of the preceding knowledge and abilities may substitute for this education and experience.

This is a new class established by the Department of Personnel and Training in July, 1989.