University of California Health Plan Operations Manager

Oakland, CA

Posted: 5/14/19
Deadline: 5/17/19
Salary: DOE

About This Organization

UC faculty and staff strive every day for excellence for the public good. They’re problem solvers, risk takers and restless pioneers.

Whether they teach students or feed them, develop the latest vaccine or administer it, write books or shelve them, everyone plays an important role in making things better for individuals, for California and for the world.

If the opportunity to join a highly effective team, to impact one of the world’s leading university systems, and to grow and develop in your career isn’t enough to get you excited, take a look the UC’s exceptional benefit package –

Job Duties


Oversee daily operations of employee self- funded health plans with over 85,000 members. Be the subject matter expert for self-funded plans with local benefit offices and staff across the 10 academic campuses, five medical centers and three national labs regarding day-to-day plan operations, implementation/operational/administrative issues, benefit interpretation/ application, and high-level customer service concerns; triage issues and consult Director as needed for resolution.
Formulates, builds and establishes objectives and strategic plans with other high level managers to proactively address key program and legislative issues. Acts as a key team member in the strategic planning process.
Primary point of contact responsible for the daily financial operations and controls for the self-funded plans to ensure program solvency. Creates timely and accurate reporting systems for executive management.
Provides financial analyses and verifies report data to internal and external constituents and stakeholders on a regular basis. Excellent interpersonal skills to effectively lead, motivate and influence others and develop and maintain high standards of customer service.
Creates and ensures timely and accurate reporting to executive management, including the EVP of UC Health, the Health Care Task Force (made up of faculty, union representatives, and other staff employees), Joint Operating Committee with Human Resources and the Executive Steering Committee, the fiduciary body for the health plans.
Identifies and prioritizes key business issues and actively takes initiative on delivering impact and solutions related to plan design and administration.
Ensures that the program tracks to set resources/budget, scope, and timeline and holds others accountable by elevating issues to appropriate divisional leadership.
Leads the development and maintenance of the provider networks by ensuring adequate network area coverage and identifying provider gaps. Directs the work of consultants and vendors to determine financial impact and secure appropriate discounts as needed for participation.
Liaison with the UC Medical Centers Managed Care Directors regarding new UCMC affiliates, rate loading, provider changes, and resolution of plan administrator issues.
Responsible for the content maintenance of the plans’ micro websites. Leads development and ongoing maintenance of the self-funded plan Program Manual, including program description, goals, all pertinent plan documentation.

Required Qualifications

Job Requirements:

Bachelor’s degree in Business Administration, Public Health Administration, Human Resources, Educational Administration or an allied field.
In place of the above requirements, the incumbent may possess any combination of relevant education and experience which would demonstrate the individual’s knowledge, skill, and ability to perform the essential duties and responsibilities listed above.
Principles and procedures of fully-insured and self-insured/self-funded health plan administration.
Requires interpersonal, service oriented, active listening and critical thinking skills.
Principles and practices required to develop, implement, and evaluate health and welfare benefit programs.
Windows and the Microsoft Office suite including word-processing, spreadsheet applications, project management and database programs.
Use original thinking and independent judgment to develop solutions reflecting the legal, policy, and operational needs of the organization. Apply initiative, resourcefulness and creativity in problem solving.
Apply political acumen to intricate situations occurring in a complex, decentralized organizational structure. Able to establish and maintain trust, confidence, and effective working relationships with colleagues and individuals of diverse occupational and social backgrounds.
Work independently, following through on assignments with minimal supervision and balancing multiple projects simultaneously with demanding timeframes. Organize, coordinate and complete projects effectively and within deadlines, while upholding a penchant for detail and a commitment to accuracy.
Principles and processes of project management

Strong organizational skills with demonstrated ability to manage multiple projects and meet deadlines. Ability to lead and pursue projects independently while exercising good judgment and exhibiting a considerable degree of creativity.
Highly developed verbal and written communications skills. Concise/precise messaging and executive level presentation material design skills are critical. Excellent ability to quickly evaluate complex issues and identify multiple options for resolution. 10 years experience managing the implementation and administration of health benefit programs, preferably self-funded plans.
Experience working in an academic institution desired.
Experience working directly in or with health care institutions a plus. Current literature, trends, and developments in the field of benefit program administration. Legal regulations applicable to employee health insurance programs (FERPA, HIPAA, PPACA, etc.).



Other Info


Required Application Materials