MANAGER, HEALTH BENEFITS POLICY, PLANNING, AND ADMINISTRATION
Manager, Health Benefits Policy, Planning, and Administration is an unclassified state title, filled by appointment and outside the tenure protections that cover the competitive ranks.
The spec names a master's degree, but it leaves the door open to substitute experience for the degree. The FY 2027 range lands between $110,276 and $162,870.
How to apply
This title is not filled by examination — agencies appoint directly.
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See where to apply for this title →Why this title is unclassified
This specification cites N.J.S.A. 11A:3-4, state unclassified service.
A title in the State unclassified service sits outside Title 11A unless a provision says otherwise. In practice that means no competitive examination to get the job, and none of the career service protections that come with it: no permanent status after a working test period, and no right of appeal to the Civil Service Commission from a removal. Appointment and removal rest with the appointing authority.
The rule that allocates a title to this service is N.J.A.C. 4A:3-1.3.
Official job specification
The text below is the official specification published by the New Jersey Civil Service Commission. The plain-language summary and analysis above are derived from it by NJ Civil Service Navigator. Source: the official specification page at NJ CSC.
Definition
Under the general supervision of an Assistant Director, Deputy Director, or other administrative official in the Division of Pensions and Benefits, Department of Treasury, coordinates and administers a complex, large-scale public health benefits program for all New Jersey public employees and their dependents, involving oversight of finance, procurement, contract administration, and information systems; analyzes health benefits policy options and develops strategic planning initiatives; proactively recommends formulation and revisions of policy, regulations, methodologies, procedures, and identifies strategies to achieve organizational goals; manages staff and work activities; prepares and signs official performance evaluations for subordinate staff; does other related duties as required.
Examples of work
Directs the background analysis for appeals, rate renewal actions, health plan data, program status updates, and benefit design. Manages the strategic planning process for health benefits designed to evaluate, recommend, and implement new programs and initiatives, including wellness initiatives to improve the health and well-being of members. Recommends health benefit policies and procedures to statewide commissions and committees appointed to approve such actions. Directs the administration of assigned vendor contracts; oversees the monitoring of service level agreements, authorization of rate renewals, and review and analysis of requests for proposal (RFPs). Oversees the monitoring of vendors; validates performance metrics to ensure compliance with vendor contracts and performance guarantees; authorizes financial penalties if performance guarantees are not met by vendors. Directs the development and authorizes the release of annual rate recommendation reports, which establish the premium rates that participating employees, employers, and retirees pay for health coverage. Oversees various fiscal management activities; plans and conducts management, statistical, organizational, fiscal, performance, and budget analyses of health benefit systems and programs. Manages and/or participates in the planning, development, implementation, procurement and/or maintenance of new or enhanced information systems for managing health benefits systems and programs. Prepares and/or oversees the preparation of written comments documenting the Division's position on newly introduced legislation affecting the State Health Benefits Program. Analyzes new laws, regulations, and contract trends to determine potential impacts on assigned health benefits programs. Attends conferences and conventions to maintain knowledge in the field and stays current with new statutory requirements impacting health benefits. Makes presentations to various groups and committees as requested regarding the assigned health benefits programs; answers complex technical inquiries and provides advice to external constituents. Directs employees and/or outside consultants assigned to audit the eligibility of plan members. Manages the work operations and/or functional programs and has responsibility for effectively recommending the hiring, firing, promoting, demoting, and/or disciplining of employees. Compiles, analyzes, and summarizes health benefit program effectiveness and emerging trends; develops related written reports, graphs, and spreadsheets. Trains and instructs subordinates on the technical aspects of health benefits programs. Will be required to learn how to utilize various types of electronic and/or manual recording and information systems used by the agency, office, or related units.
License
Appointees will be required to possess a driver's license valid in New Jersey only if the operation of a vehicle, rather than employee mobility, is necessary to perform the essential duties of the position.
Knowledge, skills and abilities
Knowledge of large-scale health benefits systems and plans. Knowledge of current laws, rules, and regulations applicable to public sector health benefits systems and plans. Knowledge of emerging healthcare best practices, data collection, data analysis, and outcomes reporting. Knowledge of current management concepts/practices. Knowledge of state contracting and related regulations, policies, codes, and rules. Knowledge of public policy formulation and implementation. Knowledge of information systems related to health benefit plans and systems. Knowledge of statistical methods and procedures and their use in the presentation of factual data related to health benefit plans and systems. Knowledge of principles/practices/procedures of supervision, employee motivation, and performance evaluation. Knowledge of the functions and organizations of state government agencies/departments. Ability to plan, carry out, and supervise analytic studies and investigations or research assignments, and to produce reports containing clear, sound, and accurate analytic data findings and recommendations including suggested implementation techniques. Ability to analyze health plan data and program operations, identify alternative program strategies, develop cost estimates, evaluate alternatives, and select the ones that are most practical and effective. Ability to communicate effectively with stakeholders including health insurance companies, appointed members of commissions and committees, Division of Pensions and Benefits personnel, negotiations representatives, etc. Ability to utilize effective written and verbal communication techniques. Ability to manage assigned staff and plan, organize, and implement projects within the unit. Ability to give constructive feedback to staff and prepare employee performance evaluations. Ability to train and instruct subordinates on the technical aspects of health benefits programs. Ability to learn how to utilize various types of electronic and/or manual recording and information systems used by the agency, office, or related units. Ability to read, write, speak, understand, and communicate in English sufficiently to perform duties of this position. American Sign Language or Braille may also be considered as acceptable forms of communication. Persons with mental or physical disabilities are eligible if they can perform the essential functions of the job with or without reasonable accommodation. If the accommodation cannot be made because it would cause the employer undue hardship, such persons may not be eligible.
Note
The examples of work for this title are for illustrative purposes only. A particular position using this title may not perform all duties listed in this job specification. Conversely, all duties performed on the job may not be listed. Applicants must meet one of the following or a combination of both experience and education. Thirty (30) semester hour credits are equal to one (1) year of relevant experience. Nine (9) years of professional experience in health benefits administration which shall have involved responsibility for finance, procurement, contract administration, information systems, policy analysis, and/or strategic planning, two (2) years of which shall have been in a supervisory capacity. OR Possession of a bachelor's degree from an accredited college or university; and five (5) years of the above-mentioned professional experience, two (2) years of which shall have been in a supervisory capacity. OR Possession of a master's degree in business administration, public administration, healthcare administration, finance, accounting, or computer science/information technology; and four (4) years of the above-mentioned professional experience, two (2) years of which shall have been in a supervisory capacity. "Professional experience" refers to work that is creative, analytical, evaluative, and interpretive; requires a range and depth of specialized knowledge of the profession's principles, concepts, theories, and practices; and is performed with the authority to act according to one's own judgment and make accurate and informed decisions.