07/29/2010 70396

STATE WORKERS’ INSURANCE FUND OPERATIONS DIRECTOR

DEFINITION: This is professional administrative work directing the operational activities of the State Workers' Insurance Fund (SWIF).

The employee in this job assists the Bureau Director in directing field operations; underwriting; and claims activities of SWIF. Work involves directing the development and implementation of standard operating procedures and other enforcement guidelines pertaining to the Workers’ Compensation claims examining and payment, reserving, auditing, insurance policy development and commutations programs; directing the fulfillment of mandated reporting requirements; coordinating the flow of information between divisions and program areas; directing customer service activities; and developing and implementing corrective action plans to eliminate inconsistency in operating procedures. Work also involves interacting and coordinating with the Chief of the Financial Management Division to ensure the integrity of financial data and establish finance related policies in conjunction with SWIF's actuaries, reinsurance brokers and investment consultants; and maintaining effective working relationships with compensation rating bureaus, investment consultants and other governmental agencies regarding Workers' Compensation and Occupational Disease programs, the Federal Black Lung Program, and vocational rehabilitation related to SWIF operations. An important aspect of the work includes translating broad policy statements into coherent processes and procedures to be followed in the processing, determination, payment of claims, and underwriting of insurance policies. Work is assigned through broad program goals and objectives and the employee exercises considerable independent judgment in determining specific goals, objectives, and priorities for assigned programs. Work is performed under the general direction of the State Workers' Insurance Fund Director and is reviewed for effectiveness of programs through conferences and evaluation of reports.

EXAMPLES OF WORK: Oversees the Workers’ Compensation claims examination and payment, reserving, and commutations programs of SWIF.

Oversees the underwriting activities of SWIF to include the auditing, insurance policy development, and reporting functions.

Oversees the field operations activities of SWIF to include managed care, investigations, and district office training programs.

Serves as Director in the Director's absence.

Translates broad policy statements into coherent processes and procedures to be followed within SWIF.

Attends board meetings to participate in discussions and assist in establishing SWIF financial, actuarial, reinsurance and investment policies.

Chairs task forces addressing issues which affect multiple program areas.

Coordinates the flow of information between divisions.

Identifies policies and procedures that provide opportunity for inconsistency or fraud in the work, services, or contractor environment, and coordinates the development and implementation of corrective action plans.

Performs the full range of supervisory duties.

The employee in this job may participate in the performance of subordinates’ work consistent with organizational and operational requirements.

Performs other related duties.

REQUIRED KNOWLEDGES, SKILLS, AND ABILITIES: Knowledge of the Pennsylvania Workers' Compensation and Occupational Disease Laws.

Knowledge of the Federal Black Lung Program.

Knowledge of insurance principles and practices.

Knowledge of insurance laws, rules and regulations.

Knowledge of the principles and practices of program administration.

Knowledge of program evaluation methodology.

Knowledge of the principles and practices of employee supervision.

Ability to read and interpret policies, procedures and laws.

Ability to establish and maintain effective working relationships

Ability to communicate effectively orally.

Ability to communicate effectively in writing.

MINIMUM EXPERIENCE AND TRAINING: One year as a State Workers’ Insurance Fund Claims Division Chief, State Workers’ Insurance Fund Underwriting Manager, or State Workers’ Insurance Fund Field Operations Division Chief;

or

Seven years of professional program planning and analysis experience in insurance underwriting, occupational compensation, or liability or casualty insurance that includes three years experience in supervising the administration of Pennsylvania Workers’ Compensation or liability or casualty insurance claims or the underwriting of Pennsylvania Workers’ Compensation insurance policies;

or

An equivalent combination of experience and training that includes three years experience in supervising the administration of Pennsylvania Workers’ Compensation or liability or casualty insurance claims or the underwriting of Pennsylvania Workers’ Compensation insurance policies.