Summary
The Deputy Associate Director, Insurance 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 Assicate Director for Insurance 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.
Requirements
Must be a U.S. Citizen or National Subject to a 1-year supervisory probationary period (unless already completed). Complete a Declaration for Federal Employment to determine your suitability for Federal employment, at the time requested by the agency If you are a male applicant born after December 31, 1959, certify that you have registered with the Selective Service System or are exempt from having to do so. File a Public Financial Disclosure Report OGE-278e within 30 days of appointment and annually from then on. You may be required to obtain and maintain an interim and/or final security clearance prior to entrance on duty. Failure to obtain and maintain the required level of clearance may result in the withdrawal of a job offer or removal. This is not a remote position, selectee will be required to report to the duty station on a regular basis. Telework may be authorized. There are three key documents that contain important information about your rights and obligations. Please read and retain these documents: Noncriminal Justice Applicant's Privacy Rights, for those who undergo an FBI fingerprint-based criminal history record check for personnel vetting, which includes Rap Back, FD-258 Privacy Act Statement - FBI (this is the same statement used when your fingerprints are submitted as part of your background investigation), and SEAD-3-Reporting-U.pdf (dni.gov), (applicable to those who hold a sensitive position or have eligibility for access to classified information)
Education
This position does not have an education requirement.
How you will be evaluated
Once the application process is complete, a review of your resume and supporting documentation will be conducted. If you meet minimum qualifications, your Application Package will be further reviewed to determine if you possess the Executive Core Qualifications (ECQ) and Mandatory Technical Qualification (MTQ) listed above. ECQs and MTQ must be thoroughly addressed within your two (2) page resume. Separate narratives will not be accepted or reviewed. Highly Qualified applicants may undergo one or more interviews and may be referred to the selecting official for further consideration. Upon selection, if not already a member of the SES serving under a career appointment, the individual selected must have his/her executive qualifications certified by the U.S. Office of Personnel Management's SES Qualifications Review Board (QRB) before appointment to this position. The selected individual's application will be forwarded to the OPM for review and certification by the QRB, unless the selectee provides evidence of their noncompetitive status (i.e., a current SES, OPM QRB certified SESCDP graduate, or SES reinstatement eligible). Upon QRB certification, the selected individual will be required to serve a one-year probationary period. For more information regarding the SES, go to Hiring and Talent Development for the Senior Executive Service.