Deputy Director of Program Services (Business & Market)
This position is located in the District of Columbia Health Benefit Exchange Authority (DCHBX). The mission of the Health Benefit Exchange Authority is to implement a state-based health insurance marketplace in the District of Columbia in accordance with the Affordable Care Act (ACA) of 2010 and the Health Benefit Exchange Authority Establishment Act of 2011, thereby ensuring access to quality and affordable health coverage to all District of Columbia residents and small businesses. The incumbent is responsible for directing, implementing, and managing all core functions of a state-based marketplace including Plan Management, Enrollment and Eligibility, Member Services, Broker Services, and Individual and SHOP marketplace. POSITION CONTROL The incumbent works under the general direction and administrative guidance of the Senior Deputy Director for Policy and Exchange Programs of the Health Benefit Exchange Authority. Incumbent is delegated broad latitude and authority in accomplishing the overall objectives and specified goals within relevant laws, regulations and major policy constraints. Incumbent confers with the Senior Deputy Director on matters that have potentially adverse or far-reaching impact on the agency. Results of the work are considered as technically authoritative, and are normally accepted without significant change. Performance is evaluated on the basis of overall effectiveness in managing the programs and functions of the HBX, achieving the desired results, and accomplishing the goals and objectives of the Senior Deputy Director. Principle guidelines include: established District of Columbia laws, regulations, policies, and procedures, including HBX regulations, policies, and procedures; pertinent federal laws, regulations, policies, and procedures; and specific instructions from the Executive Director. Guidelines also include accepted insurance principles and practices and authoritative guidance issued by the Center for Medicaid and Medicare Services (CMS), the Internal Revenue Service (IRS), and the Employee Benefits Security Administration. The incumbent is relied upon to exercise resourcefulness, judgment and ingenuity, as well extended professional experience, to either adapt standard procedures or develop new ones to fit either adapt standard procedures or develop new ones. The incumbent is recognized as a technical authority in the development and interpretation of guidelines. DUTIES AND RESPONSIBILITIES Provides leadership to and is accountable for the performance and results through multiple layers of management and senior level professional staff. Leads, directs and manages plan management staff including Qualified Health Plan (QHP) Certification, Recertification, and Decertification by the Department of Insurance, Securities and Banking for carriers whose plans are offered through the District's Health Insurance Exchange. This includes forming and maintaining strong relationships with all carriers. Makes assignments to key managerial and subordinate staff, usually in terms of the functions to be performed. Anticipates major problems and provides guidance to eliminate or minimize their effect on program operations and the population to be served. Provides advice and interpretation of policy, rules, legislation, and guidelines. Controls work results through staff meetings, conferences, technical reports, and program reviews. Makes recommendations for training and professional development and supervision of staff. Management responsibilities include leadership of programmatic teams. Provides strategic leadership in developing comprehensive plans for the conduct of in-depth studies relating to the various aspects of the business, policy and marketplace. Guides and directs the research efforts. Responsibilities include, but are not limited to: planning, coordinating, and overseeing all aspects of research programs; identifying trends in the appropriate aspects of HBX, collaborating with the management team on research priorities and strategies; and responding to requests by management for research. Participates in strategic planning processes, specifically identifying the HBX's annual strategic goals and objectives. Tracks CCIIO policy decisions, new laws and regulations affecting programs, products, and services offered by the Exchange, in coordination with the Senior Deputy Director for Policy and Exchange Programs, Agency General Counsel and the Executive Director and supports changes to ensure DCHBX compliance in program implementation. Develops, translates and executes strategies or functional/operational objectives to market participation in the Small Business Health Options Program (SHOP) to small businesses in the District of Columbia; also ensure coordination and sufficient plan involvement of carriers in the HBX. Participates with the Board of Directors, Executive Director and other senior management staff in charting the direction of the organization, in its development of products and services for both individual consumers and small businesses. Participates in identifying short-term and long-term goals and program delivery objectives for inclusion in the Senior Deputy Director's Annual Work Plans. Maintains effective working relationships with the senior management team, and staffs of the Program Services, Legal, and Information Technology in the DCHBX and other partner agencies within the District of Columbia government. Works closely with carriers, business partners, and stakeholders on development, implementation and ongoing operations. Facilitates cooperation with partner agencies internal and external to the District government on cross-agency policy and operational initiatives. Conducts periodic reviews of the key DCHBX services to assure compliance with regulations and insurance plan requirements. Manages staff responsible for gathering and analyzing data and using it to plan and manage both individual and SHOP Exchange. Leads, operationalizes and manages all reporting units Member Services, SHOP (including Congressional enrollment); Broker services, Contact Center, Enrollment and Eligibility, Navigators/Assisters/Certified Application Counselors, and other business/policy teams. Leads and manages tracking mechanisms and performance metrics for Exchange implementation and operations. Directors other to resolve highly complex or unusual business problems that affect major functions of the Exchange. Represents DCHBX at public meetings. Performs other related duties as assigned. OTHER SIGNIFICANT FACTS Mastery of federal, regional, state, and local government structure, rules, regulations, policies and procedures. Mastery of and experience in the principles of policy and administration and their application in government. Extensive knowledge of the requirements and practices to protect the security and confidentiality of private health information. Mastery of and skill in problem solving, negotiation strategies, and project management. Strong analytical skills are needed in order to evaluate and synthesize information and to develop necessary plans. Mastery of a wide range of qualitative and/or quantitative methods for assessment and improvement of program effectiveness, and the improvement of complex management processes. Mastery of financial and project management processes and techniques including, but not limited to, initial engagement, design and implementation, operational effectiveness reviews and deficiency and remediation management practices, and implementation of recommended solutions. Demonstrated skills and expertise in providing leadership in a managerial capacity and in providing leadership in a team-based environment. Ability to supervise, mentor, motivate, appraise, and work with subordinate staff. Demonstrated ability to lead and work as part of a cross-agency or cross-functional team. Demonstrated skill and expertise in implementing the Affordable Care Act (ACA) either at the federal or state level is required; and understanding of federal ACA multi-agency processes, including the multi-state plan program. Excellent facilitation, presentation, written and verbal communication skills are necessary in order to convey information clearly. Excellent interpersonal skills are required because of the need to develop effective high-level working relationships throughout the HBX and with other District and Federal Government agencies and other stakeholders. Special Requirement It is desirable that incumbent be a graduate from an accredited four year-college or university with a Bachelor's degree in public or business administration, financial management, public relations or other related field; and a minimum of five (5) year of experience in healthcare policy; or an equivalent combination of at least ten (10) years education, experience and training which exhibits the ability to perform satisfactorily in the position. A Master's degree in public policy, health policy, or related field is preferred. Experience in implementing the Affordable Care Act (ACA) either at the federal or state level is required; and understanding of federal ACA multi-agency processes, including the multi-state plan program is highly desired. Supervisory experience is required.