Director, Health Insurance Office, PSERS in Pennsylvania

Director, Health Insurance Office, PSERS

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Director, Health Insurance Office, PSERS

Salary

$112,450.00 – $167,179.00 Annually

Location

Dauphin County, PA

Job Type

Non-Civil Service Permanent Full-time

Job Number

N-2025-20681

Department

Public School Employees’ Retirement System

Division

PS Hlth Ins Off

Opening Date

03/13/2025

Closing Date

4/2/2025 11:59 PM Eastern

Job Code

05341

Position Number

00165167

Union

Non Union

Bargaining Unit

A3

Pay Group

ST12

Bureau / Division Code

00721331

Bureau / Division

PS Health Insurance Office

Worksite Address

5 North 5th Street

City

Harrisburg, Pennsylvania

Zip Code

17101

Contact Name

Doris Coomes

Contact Phone

717.720.4738

Contact Email

dcoomes@pa.gov

• Description

• Benefits

• Questions

THE POSITION

Looking for a rewarding career in retiree health care? The Public School Employees’ Retirement System (PSERS) is looking for a Director of the Health Insurance Office to oversee our unique post-employment Health Options Program administered for the sole benefit of Pennsylvania’s retired school employees. We are looking for a self-motivated, forward-thinking established leader who can navigate the evolving health insurance industry and is experienced in independently managing and monitoring health care third-party administrators and consultants to ensure PSERS continues to provide comprehensive and competitive medical and Medicare prescription drug coverage to our retirees. Due to the complexity of our program, we are looking for a candidate who possesses an in-depth practical knowledge of health insurance products and rating and underwriting principles; a working awareness and understanding of the state and federal health care legislative and regulatory environment; and a proven record of achieving overall health plan growth and exemplary performance.

Since 1994, PSERS has offered a voluntary, self-funded retiree health care plan to public school retirees, their spouses, and dependents that has expanded throughout the years to offer a variety of plans and services. Participants may select among two self-insured Medicare supplement plans, two Medicare Rx plans, and multiple Medicare Advantage plans for those eligible for Medicare. Participants not eligible for Medicare can choose our self-insured pre-65 indemnity plan. The Health Options Program also offers a fitness program and a dental and vision option through fully insured carriers. The Health Options Program has over 123,000 participants with nearly 100,000 participants in the prescription drug plan totaling over $590 million annual health plan budget.

The Health Insurance Premium Assistance Program provides a premium assistance payment for eligible PSERS retirees enrolled in an approved health insurance plan up to $100. Premium Assistance Program membership is currently over 90,000.

The Pennsylvania Public School Employees’ Retirement System (PSERS, www.psers.pa.gov (https://www.pa.gov/agencies/psers.html) ), is an agency in the Commonwealth of Pennsylvania that administers the pension plan for Pennsylvania’s public school employees. The mission of PSERS is to maintain a financially sound System that supports over a half million members with a current pension fund of approximately $70+ billion. This position will play a contributing part in ensuring PSERS fulfills its mission and values.

PSERS is located in Harrisburg, PA, a mid-size city situated along the Susquehanna River. The Harrisburg area is affordable and near many attractions including Hershey, and it is only two hours from major cities and airports like Philadelphia, Baltimore, and Washington D.C.

DESCRIPTION OF WORK

The Director of the Health Insurance Office is responsible for overseeing the administration of the voluntary, post­ employment health care programs sponsored by the Public School Employees’ Retirement Board (PSERB) for Public School Employees’ Retirement System (PSERS) members and their dependents. The post-employment health care programs include self-insured Medicare supplement plans, an employer-direct Medicare Part D prescription drug plan, a pre-65 medical plan, insured Medicare Advantage plans, pre-65 managed care plans, insured dental program and vision plans, premium assistance benefits, and a healthy lifestyle fitness program. This professional is responsible for the highest level of executive decision making on all issues for which this office is responsible.

Interested in learning more? Additional details regarding this position can be found in the position description (https://careers.employment.pa.gov/pd/PD_NEOGOV.asp?p=00165167) .

Work Schedule and Additional Information:

• Full-time employment

• Work hours are 8:30 AM to 5:00 PM, Monday – Friday, with a 60-minute lunch. Work hours are negotiable.

• This position is considered essential, meaning you may need to report to work when there is a declaration of an office closing, emergency, or disaster.

• Telework: You may have the opportunity to work from home (telework) part-time, dependent upon operational and executive leadership requirements. In order to telework, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. If you are unable to telework, you will have the option to report to the headquarters office in Harrisburg.

• Salary: In some cases, the starting salary may be non-negotiable.

• You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.

REQUIRED EXPERIENCE, TRAINING & ELIGIBILITY

QUALIFICATIONS

Minimum Experience and Training Requirements:

• Six years of professional experience in the design, implementation, and administration of a self-funded group health insurance benefit program that includes two years of experience in a supervisory or consultative capacity involving health insurance benefits experience, and a bachelor’s degree; or

• Certification as a Certified Employee Benefits Specialist and five years of professional experience in the design, implementation, and administration of a self-funded group health insurance benefit program that includes two years of experience in a supervisory or consultative capacity involving health insurance benefits experience, and a bachelor’s degree; or

• An equivalent combination of experience or training that includes two years of experience in a supervisory or consultative capacity involving health insurance benefits experience.

  Additional Requirements:

• You must be able to perform essential job functions.

  Preferred Qualifications (not required):

• Seven or more years of professional experience in the design, implementation, and administration of a self-insured group health insurance benefit program.

• Three or more years of experience in a management and leadership capacity focused on managing and monitoring health care third-party administrators and consultants .

• Five or more years of professional experience in strategic and operational planning for a health insurance benefit program.

• Five or more years of professional experience with oversight responsibility of a Medicare Part D prescription drug plan, including development of a custom formulary, and related contracted compliance services with the U.S. Department of Health and Human Services’ (HHS) Center for Medicare and Medicaid Services (CMS).

• Two or more years of professional experience in the negotiation, administration, and compliance of contracts.

• Two or more years of professional experience in budget administration.

• Two or more years of professional experience in conducting Medicare/Medigap related market analysis.

• Two or more years of working directly with a Board of Trustees or a Commission.

• Two or more years of professional experience administering a dental drug plan or a vision plan.

• Two or more years of professional experience overseeing a customer service call center and claims processing services.

• One or more years of professional experience in managing a premium assistance program.

  How to Apply:

• Your application must include acover letterandresume.

• You must attach a cover letter and resume to your application for review by the hiring manager. However, the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education).

• If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.

• Your application must be submitted by the posting closing date. Late applications and other required materials will not be accepted.

• Failure to comply with the above application requirements may eliminate you from consideration for this position.

  Veterans:

• Pennsylvania law (51 Pa. C.S. §7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to www.employment.pa.gov/Additional%20Info/Pages/default.aspx and click the Veterans’ Preference tab or contact us at ra-cs-vetpreference@pa.gov .

  Telecommunications Relay Service (TRS):

• 711 (hearing and speech disabilities or other individuals).

  If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.

The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.

Learn more about our Total Rewards by watching this shortvideo (https://www.youtube.com/embed/HtcSRnndflc?rel=0) !

See the total value of your benefits package by exploring ourbenefits calculator.

Health & Wellness

We offer multiple health plans so our employees can choose what works best for themselves and their families. Our comprehensive benefits package includes health coverage, vision, dental, and wellness programs.*

Compensation & Financial Planning

We invest in our employees by providing competitive wages and encouraging financial wellness by offering multiple ways to save money and ensure peace of mind including multiple retirement and investment plan options.

Work/Life Balance

We know there’s more to life than just work! Our generous paid leave benefits include paid vacation, paid sick leave, eight weeks of paid parental leave, military leave, and paid time off for most major U.S. holidays, as well as flexible work schedules and work-from-home opportunities.*

Values and Culture

We believe in the work we do and provide continual opportunities for our employees to grow and contribute to the greater good. As one of the largest employers in the state, we provide opportunities for internal mobility, professional development, and the opportunity to give back by participating in workplace charitable giving.

Employee Perks

Sometimes, it is the little “extras” that make a big difference. Our employees receive special employee-only discounts and rates on a variety of services and memberships.

For more information on all of these Total Rewards benefits, please visitwww.employment.pa.gov and click on the benefits box.

*Eligibility rules apply.

01

Do you possess two or more years of full-time professional experience in the design, implementation, and administration of a self-funded group health insurance benefit program in a supervisory or consultative capacity involving health insurance benefits experience?

• Yes

• No

  02

  If you are claiming experience in the above question, please list the employer(s) where you gained this experience in the text box below. The employer(s) and a description of the experience must also be included in the appropriate sections of your application if you would like the experience to be considered in the eligibility decision. If you claimed you do not have experience, type N/A in the text box below.

  03

  Do you possess valid certification as a Certified Employee Benefits Specialist?

• Yes

• No

  04

  If you are claiming certification, you must attach a copy of your certificate for your claim to be accepted toward meeting the minimum requirements. You must attach your certificate prior to the submission of your application by using the “Attachments” tab on the left. You will not be able to add your certificate to the application after it has been submitted.

  05

  How many years of full-time professional experience do you possess in the design, implementation, and administration of a self-funded group health insurance benefit program?

• 6 years or more

• 5 but less than 6 years

• 4 but less than 5 years

• 3 but less than 4 years

• 2 but less than 3 years

• Less than 2 years

• None

  06

  If you are claiming experience in the above question, please list the employer(s) where you gained this experience in the text box below. The employer(s) and a description of the experience must also be included in the appropriate sections of your application if you would like the experience to be considered in the eligibility decision. If you claimed you do not have experience, type N/A in the text box below.

  07

  How much graduate coursework have you completed in Health Care Policy and Management, Employee Benefit Administration, Business Administration, Insurance Analytics, Insurance Management, or related field? If you are claiming credits/degree, you must upload a copy of your college transcript(s) for this education to be considered in the eligibility decision. Unofficial transcripts are acceptable. You must attach your transcript(s) prior to the submission of your application by using the “Attachments” tab on the left. You will not be able to add a transcript(s) to the application after it has been submitted.

If your education was acquired outside of the United States, you must upload a copy of your foreign credential evaluation report. We can only accept foreign credential evaluations from organizations that are members of the National Association of Credential Services (NACES). A list of current NACES members can be found by visitingwww.naces.org (”www.naces.org”target=_blank”) and clicking the Evaluation Services Link.

For additional information on foreign education credentials, please visithttps://www.employment.pa.gov/Additional%20Info/Pages/default.aspx#q3and click on Other Information.

You must attach your documentation prior to the submission of your application by using the “Attachments” tab on the left. You will not be able to add a document to the application after it has been submitted.

• 30 credits or more

• Less than 30 credits

• None

  08

  Preferred Criteria: Do you have seven or more years of professional experience in the design, implementation, and administration of a self-insured group health insurance benefit program?

• Yes

• No

  09

  Preferred criteria: Do you have three or more years of experience in a management and leadership capacity focused on managing and monitoring health care third-party administrators and consultants?

• Yes

• No

  10

  Preferred criteria: Do you have five or more years of professional experience in strategic and operational planning for a health insurance benefit program?

• Yes

• No

  11

  Preferred criteria: Do you have five or more years of professional experience with oversight responsibility of a Medicare Part D prescription drug plan, including development of a custom formulary, and related contracted compliance services with the U.S. Department of Health and Human Services’ (HHS) Center for Medicare and Medicaid Services (CMS)?

• Yes

• No

  12

  Preferred Criteria: Do you have two or more years of professional experience in the negotiation, administration, and compliance of contracts?

• Yes

• No

  13

  Preferred criteria: Do you have two or more years of professional experience in budget administration?

• Yes

• No

  14

  Preferred criteria: Do you have two or more years of professional experience in conducting Medicare/Medigap related market analysis?

• Yes

• No

  15

  Preferred criteria: Do you have two or more years of experience working directly with a Board of Trustees or a Commission?

• Yes

• No

  16

  Preferred criteria: Do you have two or more years of professional experience administering a dental drug plan or a vision plan?

• Yes

• No

  17

  Preferred criteria: Do you have two or more years of professional experience overseeing a customer service call center and claims processing services?

• Yes

• No

  18

  Preferred criteria: Do you have one or more years of professional experience managing a premium assistance program?

• Yes

• No

  Required Question

Employer

Commonwealth of Pennsylvania

Address

613 North Street

Harrisburg, Pennsylvania, 17120

Website

http://www.employment.pa.gov