PURPOSE OF JOB CLASS (NATURE OF WORK)
In the Insurance Department this class is accountable for directing various programs and activities of a division or office.
Receives administrative direction from an administrative or executive official of higher grade.
Directs or assists in direction of staff as assigned.
EXAMPLES OF DUTIES
Directs staff and operations of assigned program(s); coordinates and plans program(s) activities; formulates or assists in formulation of program(s) goals and objectives; develops or assists in development of related policy; interprets and administers pertinent laws and regulations; assists in preparation of program budget; maintains contacts with individuals both within and outside of division who might impact on program activities; develops, implements and manages training programs for assigned staff consisting of on-the-job training, in-house training programs and formal education; resolves disciplinary issues; schedules field, financial, market conduct or any other related examination and/or audits of domestic insurance companies including captive companies; develops, implements and manages programs and activities related to regulation of insurance companies; may review financial analysis of companies, captive companies, holding companies, CPA audit reports and actuarial opinions related to foreign company application for licensure in Connecticut; may review examination, work papers and final reports; may direct insurance fraud and licensee enforcement related investigative activities; may manage development and implementation of managed care and/or utilization review regulatory functions and other related activities; performs related duties as required.
KNOWLEDGE, SKILL AND ABILITY
Considerable knowledge of and ability to apply relevant state and federal laws, statutes and regulations; considerable knowledge of financial and business operations, statutory accounting and examination financial procedures related to insurers, fraternal benefit societies, hospital and medical service corporations and health maintenance organizations; considerable knowledge of health benefits, case management, utilization review and managed care appeals processes; considerable knowledge of consumer issues in area of health insurance or managed care; considerable knowledge of program development and management in areas of health care, health insurance and customer service; knowledge of and ability to apply management principles and techniques; knowledge of business operations of health care providers and health maintenance organizations; knowledge of methods used by other state insurance regulatory bodies; knowledge of in-service training and instructional methods; knowledge of economic and research techniques; knowledge of state legislative process; considerable interpersonal skills; considerable oral and written communication skills; ability to interpret proposed legislation and determine application and impact on program.
MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE
Nine (9) years of experience in insurance regulation, the insurance industry, managed care or health care administration.
MINIMUM QUALIFICATIONS - SPECIAL EXPERIENCE
At least two (2) years of the General Experience must have been in a lead capacity over professional staff.
Note: For State Employees, this is interpreted at the level of Insurance Associate Examiner.
MINIMUM QUALIFICATIONS - SUBSTITUTIONS ALLOWED
1. College training may be substituted for the General Experience on the basis of fifteen (15) semester hours equalling one-half (1/2) year of experience to a maximum of four (4) years for a Bachelor's degree.
2. A Master's degree in accounting, business, health care management, insurance, finance, economics or actuarial science may be substituted for one (1) additional year of the General Experience.
3. A designation of Certified Public Accountant (CPA) and/or Certified Financial Examiner (CFE) may be substituted for one (1) additional year of the General Experience.
4. A designation of Certified Life Underwriter (CLU) or Certified Property and Casualty Underwriter (CPCU) may be substituted for one (1) additional year of the General Experience.
1. Incumbents in this class in specific program positions may be required to possess special qualifications, credentials or requirements. Examples include but are not limited to membership in the Connecticut Bar, associate or full membership in a particular actuarial society, possession of a current license as a registered professional nurse in Connecticut, or possession of a CPA,CLU OR CPCU certification and/or designation.
2. Incumbents in this class may be required to travel.
1. The following functional areas shall be assigned to class code 4997, Salary Group MP 69:
Field Financial Examination
Financial Analysis & Compliance
2. The following functional areas shall be assigned to class code 4978, Salary Group MP 67:
Consumer Affairs/P&C Life and Health
3. The following functional areas shall be assigned to class code 4977, Salary Group MP 66:
Life and Health/Managed Care Regulation
4. The following functional area shall be assigned to class code 4976, Salary Group MP 65:
Fraud, Licensee Investigations and Compliance
5. If incumbents are reassigned to a functional area with a different class code and MP group level, salary adjustments will be made in accordance with compensation calculation guidelines.
JOB CLASS DESIGNATION
(15)-Insurance Programs and Control
(1)-Officials And Administrators
This replaces the existing specification for the class of Insurance Program Manager in Salary Group MP 65 approved effective May 23, 2008. (Revised to change bargaining unit
designation during negotiations) Action No. 20-013