Deputy Associate Director, Insurance and Operations

Summary

The Deputy Associate Director, Insurance and Operations (DAD IO) reports to the Principal Deputy Associate Director (PDAD) for Healthcare and Insurance (HI) and directs the Insurance Operations organization at the U.S. Office of Personnel Management (OPM). The incumbent advises the PDAD, HI Associate Director, and the OPM Director on insurance operations (including enrollment and customer experience), contract negotiations and administration (including disputed claims), and carrier performance.

Duties

As the Deputy Associate Director, Insurance and Operations, you will be part of Healthcare and Insurance. The DAD IO will serve as a trusted advisor to the PDAD, HI AD, and OPM Director and be the subject matter expert on matters related to the operations of FEHB, PSHB, FEGLI, FEDVIP, FLTCIP, and FSAFEDS. Under the general direction of the PDAD, the incumbent manages the negotiation and administration of contracts through which insurance and other benefits are provided to eligible Federal and Postal Service employees, retirees, and their families and other eligible populations. Responsibilities encompass the Federal Employees Health Benefits (FEHB) Program, Postal Service Health Benefits (PSHB) Program, Federal Employees' Group Life Insurance (FEGLI) Program, Federal Employees Dental and Vision Insurance Program (FEDVIP), Federal Long Term Care Insurance Program (FLTCIP), and Federal Flexible Spending Account Program (FSAFEDS). The position is responsible for administering these programs efficiently and effectively, protecting enrollee interests, securing value for the Government, and supporting efforts to reduce fraud, waste, and abuse. The incumbent addresses laws, regulations, and subregulatory guidance that materially affect program operations, including eligibility, enrollment, permissible plan choices, and enrollee rights. This responsibility includes applicable provisions affecting employees of tribes, tribal organizations, tribal grant schools, retired members of the Uniformed Services, and Postal Service employees and annuitants. The incumbent coordinates with other components of HI responsible for to ensure appropriate contract oversight, operational policy implementation, performance assessment, resolution of audits resolution, and compliance with internal controls. If selected, some key responsibilities include: Directing the development, implementation, oversight, and ongoing management of the assigned insurance and benefit programs. Establishing coordinated operational priorities while addressing each program's distinct requirements. Overseeing implementation of applicable program laws, policies, regulations, and subregulatory guidance. Developing operational policies and coordinate the development of regulations and guidance, including provisions governing interagency responsibilities. Providing technical consultation and advice to OPM leadership on insurance principles and practices and on laws, regulations, and instructions relevant to HI programs. Overseeing negotiation of benefits, premiums, rates, and contract amendments for the assigned programs. Ensuring that contracts with health, dental, and vision carriers, issuers, and other contracted entities provide the best value for the Government and eligible participants. Directing acceptance and review of applications from health insurance carriers seeking to participate in the FEHB Program, PSHB Program, and FEDVIP. Overseeing the ongoing administration and management of FEHB, PSHB, FEGLI, FEDVIP, and FLTCIP carrier contracts, as well as the contract for BENEFEDS and FSAFEDS. Monitoring carrier and contractor compliance with contractual requirements, including required claims data submissions. Identify deficiencies and direct corrective action through the appropriate contractual and program processes.

Qualifications

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution. Candidates will not be hired based on their race, sex, color, religion, or national origin. To meet the minimum qualification requirements for this position, you must show that you possess the Executive Core Qualifications (ECQs) and Mandatory Technical Qualification (MTQ) related to this position within your resume - NOT TO EXCEED 2 PAGES. Resumes over the 2-page limit, will not be reviewed beyond page 2 or may be disqualified. Your resume should include examples of experience, education, and accomplishments applicable to the qualification(s). If your resume does not reflect demonstrated evidence of these qualifications, you may not receive consideration for the position. There is NO requirement to prepare a narrative statement specifically addressing the Executive Core Qualifications (ECQs) or the Mandatory Technical Qualification (MTQ) and Desirable Technical Qualification (DTQ). MANDATORY TECHNICAL QUALIFICATION (MTQ): Your resume should demonstrate accomplishments that would satisfy the mandatory technical qualification. Demonstrated comprehensive technical and administrative knowledge of insurance principles and practices, including actuarial and financing considerations, insurance industry trends, and laws, rules, and regulations related to insurance benefits programs. DESIRABLE TECHNICAL QUALIFICATION (DTQ)(OPTIONAL): Demonstrated comprehensive technical and administrative knowledge of laws, rules, and regulations related to employee health insurance and other insurance benefit programs. EXECUTIVE CORE QUALIFICATIONS (ECQs): In addition to the Mandatory Technical Qualification requirement listed above, all new entrants into the Senior Executive Service (SES) under a career appointment will be assessed for executive competency against the following five mandatory ECQs. If your 2-page resume does not reflect demonstrated evidence of the ECQs and MTQ, you may not receive further consideration for the position. There are five ECQs: ECQ 1: Commitment to the Rule of Law and the Principles of the American Founding - This core qualification requires a demonstrated knowledge of the American system of government, commitment to uphold the Constitution and the rule of law, and commitment to serve the American people. ECQ 2: Driving Efficiency - This core qualification involves the demonstrated ability to strategically and efficiently manage resources, budget effectively, cut wasteful spending, and pursue efficiency through process and technological upgrades. ECQ 3: Merit and Competence - This core qualification involves the demonstrated knowledge, ability and technical competence to effectively and reliably produce work that is of exceptional quality. ECQ 4: Leading People - This core qualification involves the demonstrated ability to lead and inspire a group toward meeting the organization's vision, mission, and goals, and to drive a high-performance, high-accountability culture. This includes, when necessary, the ability to lead people through change and to hold individuals accountable. ECQ 5: Achieving Results - This core qualification involves the demonstrated ability to achieve both individual and organizational results, and to align results to stated goals from superiors. Note: If you are a member of the SES or have been certified through successful participation in an OPM approved SES Candidate Development Program (SESCDP), or have SES reinstatement eligibility, you do not need to respond to the ECQs. Instead, you should attach proof (e.g., SF-50, Certification by OPM's SES Qualifications Review Board (QRB)) of your eligibility for noncompetitive appointment to the SES. For more information regarding the ECQs, refer to Hiring and Talent Development for the Senior Executive Service.

Education

This position does not have an education requirement.