JOB TITLE: CHIEF, DIVISION OF ADMINISTRATION AND COVERAGE, MCARE

JOB CODE: 04240

DEFINITION: This is professional managerial work directing the activities of the Administration and Coverage Compliance Division within the Bureau of Medical Care Availability and Reduction of Error Fund (Mcare) in the Pennsylvania Insurance Department.

The employee in this job is responsible for planning, managing, and evaluating the medical malpractice administration and coverage compliance programs in accordance with commonwealth laws and regulations. Work involves implementing administrative, fiscal, and operational policies and procedures related to medical malpractice insurance and resulting from statutory and primary insurer process changes; managing a liability insurance coverage program in accordance with statutory scale limits; overseeing a program to track and report medical malpractice compliance with statutory requirements of the Pennsylvania Department of State's Bureau of Professional and Occupational Affairs (BPOA); collecting and analyzing financial fee assessments received from insurance companies and approved self-insured health care providers; and managing the collection of the medical fee assessments. Supervision is exercised over professional, technical, and clerical staff. Work is performed with considerable independence and is reviewed by the Director, Bureau of Mcare through meetings, reports, and an evaluation of work products.

EXAMPLES OF WORK: (NOTE: The examples of work are representative of the work, but every position classified to this job may not perform all examples of work listed. Conversely, this is not an all-inclusive list of work examples.)

• Directs the liability insurance coverage program for Mcare eligible health care providers.

• Aligns Mcare fiscal operations and claims payments with the requirements of the Office of Comptroller, Treasury Department, Office of the Budget, and BPOA.

• Develops and recommends changes to the procedures for collecting medical malpractice assessments.

• Reviews and approves the preparation of annual guidelines and forms for assessment collections.

• Prepares and issues guidelines and procedures to ensure the compliance of health care providers, medical malpractice insurers, and agents/brokers with commonwealth laws and policies pertaining to professional liability coverage.

• Maintains a program to track and report compliance of medical providers with the statutory insurance reporting requirements of the BPOA.

• Prepares balance sheet of monthly statement of operations, including credit letters, estimated fiscal balance, and three-year average statistics report.

• Recommends investment strategies to the Treasury Department for monies generated by Mcare operations.

• Analyzes and interprets actuarial consultant projections based on Mcare assessment and expenses.

• Audits healthcare assessment premiums submitted by providers and hospitals.

• Participates with information technology staff and consultants in the development of IT projects for Mcare coverage and fiscal operations.

• Consults with departmental staff, representatives of the medical and legal communities, the public, and other stakeholders involved in the administration of medical malpractice coverage.

• Performs the full range of supervisory duties.

• The employee in this job may participate in the performance of subordinates' work consistent with operational or organizational requirements.

• Performs related work as required.

ENTRY LEVEL KNOWLEDGES, SKILLS, AND ABILITIES:

• Knowledge of the policies and practices of the medical professional liability insurance industry.

• Knowledge of the principles and practices of budgeting.

• Knowledge of the principles and practices of contracting.

• Knowledge of the principles and practices of employee supervision.

• Ability to analyze and interpret financial information.

• Ability to analyze and interpret policies and procedures.

• Ability to establish and maintain effective working relationships.

• Ability to effectively communicate orally.

• Ability to effectively communicate in writing.

MINIMUM EXPERIENCE AND TRAINING: (NOTE: Based on the Entry Level Knowledges, Skills, and Abilities)

• Five years of professional experience managing a medical malpractice insurance program, including one year of supervisory experience and a bachelor’s degree that includes or is supplemented by 15 college credits in accounting or a related field;

or

• An equivalent combination of experience and training that includes one year of professional supervisory experience in a medical malpractice insurance program and 15 college credits in accounting or a related field.