HEALTH INSURANCE CONTRACT PROFESSIONAL - 72003091

Requisition No: 837393 

Agency: Management Services

Working Title: HEALTH INSURANCE CONTRACT PROFESSIONAL - 72003091

 Pay Plan: Career Service

Position Number: 72003091 

Salary:  $52,500 to $58,500 

Posting Closing Date: 10/10/2024 

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Health Insurance Contract Professional

Division of State Group Insurance

State of Florida Department of Management Services

This position is located in Tallahassee, FL

Position Overview and Responsibilities:

The Department is seeking a highly motivated professional to serve as a Health Insurance Contract Professional (Contract Professional). The selected candidate will be a subject matter expert for the preferred provider organization (PPO) services, health maintenance organization (HMO) services, prescription drug plan (PDP) services, dental, vision, or other supplemental health plans. The Contract Professional must have a sound understanding of the state and federal rules, contract management, and policies and procedures governing state benefit programs. These policies and procedures significantly impact how carrier (vendor) contracts and programs are managed and administered. This position requires a high degree of confidentiality, accuracy, and adherence to timeframes.

As a member of the team, the Contract Professional will manage one or more of our health services contracts for PPO, HMO, PDP, dental, vision, and/or supplemental health plans, ensuring consistent application of policies, terms, and directives. The Contract Professional will provide benefit coverage interpretations to internal management, plan members, providers, and other interested parties.

This role will frequently engage with providers and stakeholders to educate and communicate the expectations, performance measures, and procedures of each assigned contract. In the event of performance deficiencies, you will assist in the development of corrective action plans and monitor accordingly. Additionally, you will leverage your analytical side through the analysis of provider data and prepping reports comparing and summarizing vendor performance.

Assist and support with the development and creation of bid specifications and associated legal notifications for benefit procurement initiatives, evaluates respondent submissions, and participates in contract negotiations with health related and/or health insurance companies when applicable. As a subject matter expert, the Contract Professional will be the go-to for industry trends, and potential enhancements for these programs. This also includes participating in training and educational activities such as Open Enrollment benefit fairs. 

Knowledge, Skills, and Abilities:

• Knowledge of Florida Statutes, and policies and procedures governing the state group insurance programs, including Chapter 60P, Florida Administrative Code.
• Knowledge of Federal laws, rules and regulations governing or affecting state group insurance programs including, but not limited to Section 125 of the IRS Code, COBRA, Medicare, ACA and HIPAA.
• Knowledge of Florida Insurance Code and/or Florida procurement laws and/or employee group benefits.
• Ability to work with a variety of stakeholders in sometimes-difficult situations while maintaining professionalism and world-class customer service.
• Strong written and oral communication skills.
• Strong organizational skills.
• Proficiency in Microsoft Office Suite (e.g., Outlook, SharePoint, Microsoft Word, Excel, PowerPoint).
• Ability to work effectively within a team-based work group that consists of state employees, contractors, procurement respondents, and attorneys.
• Ability to utilize problem-solving techniques.
• Ability to effectively and efficiently work both independently and as a contributing member of a team.
• Ability to plan, organize and prioritize own and other’s work assignments to meet deadlines.
• Ability to identify operational efficiencies and develop innovative solutions to solve issues, improve processes, and/or create cost savings.
• Accountability, Communication, Teamwork, Empowerment, Flexibility, Integrity, Respect, Teamwork.

Minimum Qualifications:

• Minimum of three years of experience in contract management, grant management, employee group benefits program administration, or human resources benefits administration.
• Experience managing short- and long-term projects with numerous tasks and owners.
• Demonstrated ability to effectively communicate complex information to stakeholders of various levels.
• Ability to effectively use Microsoft Office production software (e.g., Outlook, SharePoint, Microsoft Word, Excel, PowerPoint).
• Florida Certified Contract Manager (FCCM) or the ability to obtain within the first six months of employment is required.

Preferred qualifications:

• At least three years of experience managing high-cost contracts.
• Experience administering or managing health and/or voluntary benefit programs (e.g., dental, vision, life).
• Experience successfully managing vendor contract transitions on tight timeframes.
• Experience developing competitive solicitations and negotiating contract terms.
• Knowledge of federal laws, rules and regulations governing or affecting employer group insurance including, but not limited to, Section 125 of the Internal Revenue Code, COBRA, Medicare, ACA, and HIPAA.
• Florida Certified Contract Negotiator (FCCN) certification or the ability to obtain within the first twelve months of employment.

Our Organization and Mission:
Under the direction of Governor Ron DeSantis, Secretary Pedro Allende and DMS’ Executive Leadership Team, the Florida Department of Management Services (DMS) is a customer-oriented agency with a broad portfolio that includes the efficient use and management of real estate, procurement, human resources, group insurance, retirement, telecommunications, fleet, and federal property assistance programs used throughout Florida’s state government. It is against this backdrop that DMS strives to demonstrate its motto, “We serve those who serve Florida.”

Special Notes:
DMS is committed to successfully recruiting and onboarding talented and skilled individuals into its workforce. We recognize the extensive training, experience, and transferrable skills that veterans and individuals with disabilities bring to the workforce.  Veterans and individuals with disabilities are encouraged to contact our recruiter for guidance and answers to questions through the following provided email addresses:
DMS.Ability@dms.fl.gov
DMS.Veterans@dms.fl.gov
An individual with a disability is qualified if he or she satisfies the skills, experience, and other job related requirements for a position and can perform the essential functions of the position with or without reasonable accommodation. Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must contact the DMS Human Resources (HR) Office at (850) 488-2707. DMS requests applicants notify HR in advance to allow sufficient time to provide the accommodation.
Successful completion of background screening will be required for this position.

The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.

Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.

The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.

VETERANS’ PREFERENCE.  Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans’ Preference will receive preference in employment for Career Service vacancies and are encouraged to apply.  Certain service members may be eligible to receive waivers for postsecondary educational requirements.  Candidates claiming Veterans’ Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code.  Veterans’ Preference documentation requirements are available by clicking here.  All documentation is due by the close of the vacancy announcement.