Louisiana
The Division of Administration/Office of Group Benefits has a vacancy. This position serves as the Group Benefits Analyst in the Medical/Pharmacy Section of the Office of Group Benefits (OGB) and has the responsibility for providing support and assistance to OGB management and staff, Third Party Administrators (TPAs) and OGB plan members. OGB is responsible for managing a statewide employer based comprehensive benefits program for over 230,000 employees, retirees and their dependents at the State of Louisiana, school boards and other governmental subdivisions. OGB’s Management functions consists of oversight in the administration of benefits provided by TPAs while insuring overall program cost, containment and compliance with federal and state mandates.
Key Competencies
Building and Supporting Teams:
The ability to combine one's actions and efforts with others to work toward achieving a common goal.
Communicating Effectively:
The ability to convey information, ideas, and emotions using structured communication methods that promote understanding and engagement.
Making Accurate Judgments:
The ability to assess options, weigh risks, and make sound decisions using available information and logical reasoning.
Three years of experience in employee benefits, health services, health insurance claims processing, or contracts; OR
Six years of full‑time work experience in any field; OR
A bachelor's degree.
EXPERIENCE SUBSTITUTION: Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full‑time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.
The official job specifications for this role, as defined by the State Civil Service, can be found.
Job Duties Serves as the principal assistant to the ASO and Self‑Funded health plans. Review and reconcile monthly and weekly TPA invoices to confirm amounts billed for plan member’s benefits, claims and counts are accurate and complete. Responsible to correct and report any discrepancies discovered during the reconciliation process. Communicate with TPA representatives and OGB staff to request documentation needed to correct discrepancies. Coordinate with OGB staff, the Office of Finance and Support Services (OFSS) and TPAs for payment of weekly and monthly vendors’ invoices. Maintain Med/Pharm required spreadsheets to document TPA/vendors weekly/monthly invoices, rebates, payments and/or pass through amounts. Perform vendor audits and analysis as requested by OGB Management. Participate in all implementation efforts for TPAs required by OGB Management. Research and review reports submitted to OGB from vendors regarding plan participation, eligibility, data errors, problems, etc. Research and analyze complex rules, regulations and laws applicable to OGB’s membership and eligibility. Collaborate with vendors, the Office of Technology Services (OTS) and/or agency personnel for problem resolution. Assist in the development of presentations, workshops, seminars, etc. for delivery to agency personnel on medical/pharmacy benefits subject matter. Represent OGB for Annual Enrollment periods as needed. Develop work processes to aid in the oversight and compliance with federal and state mandates. Assist other Medical/Pharmacy Sections when necessary with system updates, reporting, etc. and perform other duties as requested by manager, director or administrator. Other duties as assigned.
Position Details
Appointment Type:
This vacancy will be filled by a new hire or by promotion of a current permanent status classified employee. A permanent status employee may be required to serve a new probationary period in lieu of promotion.
Louisiana is a State as a Model Employer for People with Disabilities.
Career Progression:
This vacancy participates in a career progression group and may be filled from this recruitment as a Group Benefits Analyst 1, 2, or 3, depending on the level of experience of the selected applicant.
Compensation:
This position receives a retentions pay of $1.00 per hour for each hour worked
How To Apply No Civil Service test score
is required in order to be considered for this vacancy.
To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.
* Information to support your eligibility for this job title must be included in the application (i.e., relevant, detailed experience/education). Resumes
will not
be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.
A criminal history check may be conducted on all new hires as well as employees changing positions, including promotions, demotions, details, reassignments and transfers. Also, prospective employees may be subject to pre‑employment drug testing. New hires will be subject to employment eligibility verification via the federal government’s E‑verify system.
Applicants qualifying based on college training or receipt of a baccalaureate degree will be required to submit an official college transcript to verify credentials claimed prior to appointment. Please make every effort to attach a copy of your transcript to your application. The transcripts can be added as an attachment to your online application. The selected candidate will be required to submit original documentation upon hire.
For further information about this posting, please contact: Erica R. Gay HR Specialist Division of Administration/Office of Human Resources email: Erica.Gay@la.gov
#J-18808-Ljbffr
Key Competencies
Building and Supporting Teams:
The ability to combine one's actions and efforts with others to work toward achieving a common goal.
Communicating Effectively:
The ability to convey information, ideas, and emotions using structured communication methods that promote understanding and engagement.
Making Accurate Judgments:
The ability to assess options, weigh risks, and make sound decisions using available information and logical reasoning.
Three years of experience in employee benefits, health services, health insurance claims processing, or contracts; OR
Six years of full‑time work experience in any field; OR
A bachelor's degree.
EXPERIENCE SUBSTITUTION: Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full‑time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.
The official job specifications for this role, as defined by the State Civil Service, can be found.
Job Duties Serves as the principal assistant to the ASO and Self‑Funded health plans. Review and reconcile monthly and weekly TPA invoices to confirm amounts billed for plan member’s benefits, claims and counts are accurate and complete. Responsible to correct and report any discrepancies discovered during the reconciliation process. Communicate with TPA representatives and OGB staff to request documentation needed to correct discrepancies. Coordinate with OGB staff, the Office of Finance and Support Services (OFSS) and TPAs for payment of weekly and monthly vendors’ invoices. Maintain Med/Pharm required spreadsheets to document TPA/vendors weekly/monthly invoices, rebates, payments and/or pass through amounts. Perform vendor audits and analysis as requested by OGB Management. Participate in all implementation efforts for TPAs required by OGB Management. Research and review reports submitted to OGB from vendors regarding plan participation, eligibility, data errors, problems, etc. Research and analyze complex rules, regulations and laws applicable to OGB’s membership and eligibility. Collaborate with vendors, the Office of Technology Services (OTS) and/or agency personnel for problem resolution. Assist in the development of presentations, workshops, seminars, etc. for delivery to agency personnel on medical/pharmacy benefits subject matter. Represent OGB for Annual Enrollment periods as needed. Develop work processes to aid in the oversight and compliance with federal and state mandates. Assist other Medical/Pharmacy Sections when necessary with system updates, reporting, etc. and perform other duties as requested by manager, director or administrator. Other duties as assigned.
Position Details
Appointment Type:
This vacancy will be filled by a new hire or by promotion of a current permanent status classified employee. A permanent status employee may be required to serve a new probationary period in lieu of promotion.
Louisiana is a State as a Model Employer for People with Disabilities.
Career Progression:
This vacancy participates in a career progression group and may be filled from this recruitment as a Group Benefits Analyst 1, 2, or 3, depending on the level of experience of the selected applicant.
Compensation:
This position receives a retentions pay of $1.00 per hour for each hour worked
How To Apply No Civil Service test score
is required in order to be considered for this vacancy.
To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.
* Information to support your eligibility for this job title must be included in the application (i.e., relevant, detailed experience/education). Resumes
will not
be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.
A criminal history check may be conducted on all new hires as well as employees changing positions, including promotions, demotions, details, reassignments and transfers. Also, prospective employees may be subject to pre‑employment drug testing. New hires will be subject to employment eligibility verification via the federal government’s E‑verify system.
Applicants qualifying based on college training or receipt of a baccalaureate degree will be required to submit an official college transcript to verify credentials claimed prior to appointment. Please make every effort to attach a copy of your transcript to your application. The transcripts can be added as an attachment to your online application. The selected candidate will be required to submit original documentation upon hire.
For further information about this posting, please contact: Erica R. Gay HR Specialist Division of Administration/Office of Human Resources email: Erica.Gay@la.gov
#J-18808-Ljbffr