Description

Overview

Providing health benefits to more than 5600 graduate and undergraduate students and their dependents, Princeton University‘s self-insured Student Health Plan (SHP) and group health dental and vision plans are critical components of the University’s approach to promoting the health and wellbeing of its student population, working in partnership with other services provided directly by the University Health Services organization. The University provides significant support to the cost of the SHP and group health plans through the direct support of the dependent SPH fees, a 50% subsidy of the group health plan fees and through the generous financial aid that helps graduate and undergraduate students pay for their SHP fees.

Given the continuing growth in the size, complexity, and importance of our self-insured Student Health Plan and Group Health Plans, Princeton University has created a new position of Associate Director of Student Health Plans to coordinate all aspects of plan administration and to communicate all of the benefits of the Plans to campus constituencies. Under the aegis of the Vice President for Campus Life, the Associate Director will manage an existing team of three administrators in University Health Services and work closely with colleagues in the University’s Office of Finance and Treasury, the Provost’s Office, the Graduate School, the Undergraduate College and other partners in administering the Plans.

The successful candidate will:

Provide oversight to and management of all operational aspects of the Student Health Plan and Group Dental and Vision Plans including managing and overseeing the SHP Office and its staff. Provide staff support to the various SHP governance committees and working groups. Lead key projects with key stakeholders including students, as new programs or services are developed or as existing programs or services evolve. In coordination with other University departments, provide management of all plan vendors and service providers and related contracts and agreements. Use health plan analytics and periodic student survey data to assist governance in decision making around Plan benefits and design. Monitor industry trends and regulatory standards through regular engagement with national and higher education groups, state and federal governments and vendors on matters relating to the student health plans in order to ensure compliance with all regulatory requirements, with special emphasis on ACA certification and CMS requirements. Oversee the development and dissemination of all materials, brochures, and plan documents to the SHP website.

Responsibilities

Operations

• Overseeing all operational aspects of the University’s ACA-certified self-insured Student Health Plan and Group Dental and Vision Plans.
• Providing staff support to SHP governance committees and work groups to include meeting scheduling, agenda and minutes preparation and maintenance of all committee materials and reports. Committees include the planned SHP Benefits Committee (SHPBC), the SHP Operations Group, Student Health Plan Advisory Council (SHPAC) and other committees and work groups as formed from time to time.
• Administering SHP and Group Health Plan surveys every other year, analyzing and sharing results with SHP governance and student stakeholders, tracking trends in satisfaction and using data to help inform future decisions regarding changes to plan design and benefits.

Vendor relations and management

• In coordination with the AVP of Risk Management, negotiating medical TPA fees and Dental and Vision plan fees on an annual basis. The Associate Director, with the assistance of the AVP of Risk Management, will periodically remarket all vendor services and health plan contracts.
• Managing all of the day-to-day SHP related activities of the service contracts and vendors (third party network and claims administrator, prescription drug program manager, IRS reporting). This will require coordination with Risk Management, and for the prescription drug contract and vendors, will require coordination with Human Resources.
• Conducting at least bi-annual review meetings with key vendors.

Plan Analytics

• Preparing monthly review and analysis of medical and prescription drug utilization and claims reports, and quarterly utilization and dashboard reports for review by the governance committees.
• Producing utilization reports and making recommendations regarding plan changes or design modifications as required or indicated for consideration by governance committees.

Regulatory Compliance

• Maintaining awareness of and knowledge about emerging legislation (federal and state) having an impact on and/or requiring changes to the SHP.
• Monitoring trends and regulatory standards through regular engagement with national advocacy organizations, federal and state government and vendor partners, and advising University leadership and SHP governance committees as needed.
• Ensuring that the SHP complies with all ACA and New Jersey State Mandates, and that SHP documents (Plan, Design Summary, SBC) have been submitted to CMS before implementation of plan changes as required by CMS.
• Maintaining all records and correspondence related to CMS submissions, CMS reviews and certification status.
• Maintaining and retaining all Student Health Plan documents (Plan, Design Summary, SBC) for each plan year and for any interim plan year changes.
• Ensuring that all personnel involved in SHP operations have received initial and updated annual HIPAA and FERPA training as required by University policies /procedures and maintaining a log of all trainings.

Management

• Managing and Overseeing the SHP Office and its staff to include: the management of the SHP and Group Health Plan (Dental and Vision) enrollment processes and ongoing process improvement efforts working with UHS colleagues and campus partners that onboard new students.
• Overseeing customer service functions and claims issues and claims appeals, in coordination with ASH.
• Managing the SHP website, including posting of documents on the UHS/SHP website.

Communication and Marketing

• Developing marketing and communications strategies; overseeing the development of brochures and other promotional materials; and submitting material for the Student Health Plan website, all intended to increase understanding of the Plan’s operations, benefits, and finances amongst various campus constituencies. This will include developing an outreach strategy for improving communication with Plan members.

Requirements

Qualifications

ESSENTIAL QUALIFICATIONS

• Strong knowledge of health insurance/benefits plan design and administration.
• Certified Employee Benefits Specialist (CEBS)

• Bachelor's degree and Five years of progressive experience in administering health insurance plans/products

• Project management and/or analysis in the healthcare field.
• Financial analysis and management skills appropriate to manage complex plan designs and budgets.
• Understanding of state and federal laws applying to student health insurance/benefit plans.
• Proven skills in written and oral communications
• Experience with team building, leadership, and supervision.
• Experience synthesizing materials into proposals for strategic projects and decision support.
• Proficiency in Microsoft Office Suite, with demonstrated expertise in the use of Excel for analyses.

Princeton University is an Equal Opportunity/Affirmative Action Employer and all qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status, or any other characteristic protected by law. EEO IS THE LAW

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PI146669259