Job Description: MANAGED RISK MEDICAL INSURANCE BOARD IS RECRUITING TO FILL TWO VACANCIES
General Description of Duties:
This is a journey level position which performs the more technical analytical assignments independently and sometimes as a member of a team, such as program evaluation and planning, policy analysis and formulation, systems development, budgeting, planning, management, and personnel analysis. Duties will be assignd commensurate to the classification at which filled. The incumbent studies the principles and techniques of the area of work to which assigned and under supervision and applies them. The incumbent participates in analytical studies of organization, procedures, budgetary requirements, and personnel management. Gathers, tabulates, and analyzes data; draws organization, workload, and other charts. Meets and consults with Board management, employees, and others to give and secure information; prepares reports and makes recommendations on procedures, policies, and program alternatives. Reviews and analyzes proposed legislation and advises management in areas of average complexity. Works as a Board representative in intergovernmental negotiations and prepares correspondence.
Conduct research and adjudicate the more complex HFP subscriber appeals of eligibility, enrollment, and effective date of coverage decisions. Develop written recommendations to management of the appeal decision. Develop the supporting case file, in consultation with legal staff, for appeals that escalate to a review by an Administrative Law Judge from the Office of Administrative Hearings. Provide support for adjudication of appeals and hearings for the Access for Infants and Mothers Program (AIM), Pre-Existing Insurance Program (PCIP), Healthy Families Program (HFP) and Major Risk Medical Insurance Program (MRMIP) . May provide bilingual services such as translation for written recommendations to management, translation for AIM and HFP material, and work directly with bi-lingual applicants in their first language.
Develop and monitor eligibility and enrollment policies and procedures, program operations and program notices for compliance with state and Federal standards and Board policy. Manage complex projects requiring the individual to lead a team and the project with little supervision. This may include on-site monitoring of the administrative vendor and ongoing County Children’s Health Insurance Program (C-CHIP) case reviews.
Extensive interpretation of state and Federal eligibility statutes, regulations, policies and guidelines to the HFP administrative vendor, enrolled subscribers, and the general public. Provide support for these functions for the AIM, PCIP, C-CHIP, HFP and MRMIP.
Represent the MRMIB in statewide stakeholder communication efforts in small and large group settings. Including public speaking about the AIM, PCIP, C-CHIP, HFP and MRMIP. Review, edit, and make recommendations on stakeholder program materials for distribution to the general public and program applicants. This may include program application and handbook updates. Provide support for the review of health, dental, and vision plan marketing plans and materials, changes to the Board and program websites or the State’s on-line enrollment portal.
As assigned, attend Board meetings and make technical presentations to the Board on eligibility and enrollment policies and issues. Prepare correspondence to document remedial actions required for compliance with State and Federal statutes and requirements.
• Must possess and maintain sufficient strength, agility, endurance, and sensory ability to perform the duties contained in this duty statement with or without reasonable accommodation.
Typical Working Conditions:
• Requires prolonged sitting, use of telephone and use of personal computers.
• High volume of customer service to subscribers and technical support to administrative vendors.
• Contact with employees from the Department of Health Care Services, contracted health, dental and vision plans, the contracted administrative vendors, various county government and public entities interested in a county children’s health initiatives.
• Requires the incumbent to travel periodically within the State and perform overtime as necessary. Normal hours of work include Monday through Friday 8 a.m. to 5 p.m.
• Demonstrates a commitment to exceptional performance of duties in a service-oriented manner.
• Ability to multi-task and meet deadlines.
• Demonstrates a commitment to maintaining a work environment free from discrimination and sexual harassment.
• Maintains good work habits and adheres to all policies and procedures.
• Demonstrates the ability to work independently as well as a member of a team.
• Effectively communicate orally and in writing with administrative vendors, management, co-workers, and the public.
• Ability to speak Spanish.
Who May Apply:
Individuals who are currently appointed at the Associate Governmental Program Analyst or Staff Services Analyst (G) level or who have list, transfer or reinstatement eligibility may apply. Only the most qualified candidates will be interviewed. Hire may be restricted to SROA or surplus state employees. Duties will be commensurate to the level at which filled. To apply for this position, you must submit a Std. 678, State Application (available at www.calhr.ca.gov). In the Explanation Section of the application enter JOB ID# 12-EEM-013 and Position # 443-300-5393/5157-XX2 and the basis for eligibility. For list eligible candidates, please attach your exam results. Please mail your application to:
Managed Risk Medical Insurance Board
1000 G Street, Suite 450
Sacramento, CA 95814
Attn: Penni Correa- Personnel
E-mail applications will not be accepted. Applications received for this recruitment may be considered for additional vacancies. Applications must be postmarked or received at the above listed address by the final filing date, February 19, 2013.
If you have questions regarding this information, please contact Penni Correa, 916-323-4138.
Equal Employment Opportunity Employer to all regardless of race, color, creed, national origin, ancestry, sex, marital status, disability, religious or political affiliation, age or sexual orientation.
If you are not a current or former State employee, you must first take an examination to obtain list eligibility. This does not apply to Student Assistant vacancies.
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The State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.