Director of Rates

Department Information

Hybrid Workplace Arrangement: Although this position will be designated under the department’s hybrid workplace program, it will still be required to report to the department office on a scheduled basis and at the discretion of the supervisor, based on business needs. This announcement may be used to fill multiple vacancies.

The Department of Regulatory Agencies (DORA) is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado. Consumer protection is our mission. DORA values and promotes diversity, supporting a workplace that is inclusive of people from different backgrounds and experiences; creating an environment that is reflective of our communities; promoting positive relationships; and putting forth unique perspectives to fulfill our mission.

Employer-sponsored RTD EcoPass, with offices located at Civic Center Plaza, above the RTD Civic Center station and just a few blocks from RTD light rail. Extensive work-life programs such as flexible schedules, training and professional development opportunities on a wide variety of subjects, and more Employee wellness programs, including the Colorado State Employee Assistance Program (CSEAP), which provides free, confidential counseling services. Bike-to-work programs, including access to storage lockers and bike racks. Flexible retirement benefits, including a choice of the PERA Defined Benefit Plan or the PERA Defined Contribution Plan, plus optional 401K and 457 plans.

Medical and Dental Health Insurance for employees and optional coverage for their dependents. Life Insurance for employees, and optional coverage for their dependents. Paid Time Off, including 11 paid holidays.

Short- and long-term disability coverage. Tuition assistance program. Check out our excellent benefits package

Description of Job

The Colorado Division of Insurance (DOI) regulates the insurance industry in Colorado. DOI helps consumers by answering their questions, investigating their complaints, and helping them to understand their insurance. The division regulates and monitors insurance companies in Colorado, as well as insurance agents, ensuring all are following the law.

The Life and Health Rates and Forms work unit is responsible for reviewing insurance plan filings and policy forms and enforcing company compliance with Federal and State statutes and regulations. This unit promotes the availability of insurance products through adequate regulation, assures the relevant insurance products comply with statutory mandates, protects consumers through adequate regulatory activity, and provides meaningful and reliable information to consumers and the industry.

This unit also enforces insurance laws by prohibiting deceptive or misleading practices relating to policy forms. In addition, the unit is responsible for ensuring compliance with Qualified Health Benefit Plan laws, Essential Health Benefit coverage requirements, compliance with laws related to marketing materials, and provider network adequacy. The position will also be a main point of contact with Connect for Health Colorado and Colorado’s health insurance marketplace.

Position: SFA 4126 This position is the Director of Rates and Forms for the Life, Accident and Health sections in the division, and is responsible for the supervision of eight direct reports in the work unit. The position is in regular contact with insurance company representatives and federal regulators in matters of health-related legislation.

In addition, the position is one of the main points of contact between the division and Connect for Health Colorado - the state's health insurance marketplace. In functioning as the unit supervisor, this position is responsible for developing staffing and consultant requirements, procedures for the review of health insurance plans, and the training of staff to do the same. As part of that role, the position is also responsible for filling vacancies in the unit, and hiring, managing and training both full-time employees and contract staff, form reviewers, and others on an as-needed basis.

Adhering to statutory requirements, the position is responsible for developing and maintaining the regulations applicable to rates and forms for the life, accident and health lines of authority. This includes regulations that are necessary to maintain compliance with the Affordable Care Act (ACA). The position also develops and updates regulations and guidance to the insurance industry as the federal government changes its regulations and guidance.

Additional duties include, but are not limited to: Working with direct reports, senior management and the Commissioner to accomplish the division's mission and strategic goals, including planning and budgeting for staff and resources to fulfill the section's mission; Hiring and managing contract staff on an as-needed basis;

Developing guidelines to ensure the forms, binders, and provider networks that are filed meet statutory and regulatory requirements; Managing performance of staff to ensure compliance with the state's personnel rules, performance management system, and department and division policies and procedures; Monitoring pending federal and state legislation, industry practices, and issues raised in other states to determine the impact on the division and Colorado insurance consumers;

Recommending amendments to rules, regulations and bulletins related to topics applicable to the Rates and Forms Section for life, accident and health to the Deputy Commissioner; Streamlining processes and eliminating waste to keep costs low, while maintaining high-quality products and services; and Incorporating change management initiatives into process improvements and procedural changes to minimize employee resistance and maximize employee engagement.

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

MINIMUM QUALIFICATIONS (MQs): There are two ways to qualify for this position: 1) Experience OR 2) A Combination of Education and Experience Option 1: Experience Nine (9) years of full-time professional

• work experience in at least one (1) of the following three (3) areas:

Working in the insurance industry establishing rates, handling claims, underwriting, and policy services (involving interpreting and answering in-depth questions on policy provisions); OR Working in the insurance or financial industry conducting audits or investigations requiring financial analysis, or monitoring for and enforcing compliance with financial industry or insurance industry-related laws, rules, policies, and regulations; OR Working in a regulatory environment performing form and policy reviews, field market conduct examinations and/or audits, analysis of insurance practices, and use of market analysis tools.

Of the nine (9) years, one (1) year must include formal*

• supervisory experience over professional level staff, including reviewing and evaluating work produced by subordinates to provide feedback and coaching when appropriate, and/or professional
• project management experience, including delegating and effectively prioritizing tasks; documenting processes and operations; managing resources; monitoring and driving progress; reporting outcomes; and ensuring project milestones and deadlines are met.

Option 2: A Combination of Education AND Experience Associate’s Degree and Experience:Graduation from an accredited college or university with an associate’s degree in business, business administration, business management, project management, public health, healthcare administration, healthcare management, healthcare law, or a field of study related to the work assignment; AND Seven (7) years of full-time professional

• work experience in at least one (1) of the following three (3) areas:

Working in the insurance industry establishing rates, handling claims, underwriting, and policy services (involving interpreting and answering in-depth questions on policy provisions); OR Working in the insurance or financial industry conducting audits or investigations requiring financial analysis, or monitoring for and enforcing compliance with financial industry or insurance industry-related laws, rules, policies, and regulations; OR Working in a regulatory environment performing form and policy reviews, field market conduct examinations and/or audits, analysis of insurance practices, and use of market analysis tools.

Of the seven (7) years, one (1) year must include formal*

• supervisory experience over professional level staff, including reviewing and evaluating work produced by subordinates to provide feedback and coaching when appropriate, and/or professional
• project management experience, including delegating and effectively prioritizing tasks; documenting processes and operations; managing resources; monitoring and driving progress; reporting outcomes; and ensuring project milestones and deadlines are met.

Certification, registration, or licensure as an Associate Professional in Insurance Regulation (APIR) designation or a similar professional designation related to the work assigned will count for one (1) year of the requirement. OR Bachelor’s Degree and Experience: Graduation from an accredited college or university with a bachelor's degree in business, business administration, business management, project management, public health, healthcare administration, healthcare management, healthcare law, or a field of study related to the work assignment; AND Five (5) years of full-time professional

• work experience in at least one (1) of the following three (3) areas:

Working in the insurance industry establishing rates, handling claims, underwriting, and policy services (involving interpreting and answering in-depth questions on policy provisions); OR Working in the insurance or financial industry conducting audits or investigations requiring financial analysis, or monitoring for and enforcing compliance with financial industry or insurance industry-related laws, rules, policies, and regulations; OR Working in a regulatory environment performing form and policy reviews, field market conduct examinations and/or audits, analysis of insurance practices, and use of market analysis tools.

Of the five (5) years, one (1) year must include formal*

• supervisory experience over professional level staff, including reviewing and evaluating work produced by subordinates to provide feedback and coaching when appropriate, and/or professional
• project management experience, including delegating and effectively prioritizing tasks; documenting processes and operations; managing resources; monitoring and driving progress; reporting outcomes; and ensuring project milestones and deadlines are met.

Certification, registration, or licensure as an Associate Professional in Insurance Regulation (APIR) designation or a similar professional designation related to the work assigned will count for one (1) year of the requirement. Document this experience in your application IN DETAIL, as your experience will not be inferred or assumed. Part time experience will be prorated.

SUBSTITUTIONS: Partial credit toward the degree requirement will be given for completed college/university coursework that did not result in a degree. A master's or doctorate degree from an accredited college or university in a field of study related to the work assignment will substitute for the bachelor's degree requirement.

• Professional work involves exercising discretion, analytical skill, judgment and personal accountability and responsibility for creating, developing, integrating, applying, and sharing an organized body of knowledge that characteristically is: uniquely acquired through an intense education or training regimen at a recognized college or university; equivalent to the curriculum requirements for a bachelor's or higher degree with major study in or pertinent to the specialized field; and continuously studied to explore, extend, and use additional discoveries, interpretations, and application and to improve data, materials, equipment, applications and methods.

• Formal supervisory experience requires accountability for the quality and quantity of work of at least 3 full-time employees of the organization; responsibility for making decisions that affect the pay, status and/or tenure of subordinates; and authority in the hiring, performance planning and evaluation and progressive discipline processes.

Preferred Qualifications: Demonstrated professional

• experience reviewing federal and state laws, statutes, and regulations;

Demonstrated professional

• experience with project management, including prioritization and delegation of tasks and monitoring progress;

Experience reviewing insurance company's advertising and marketing materials for compliance; Demonstrated professional

• supervisory experience, including reviewing and evaluating work produced by subordinates to provide feedback and coaching when appropriate;

Experience in insurance product building and development, including reviewing rates and forms related to products; Experience making recommendations for company and producer enforcement actions; Experience collaborating with other insurance regulators in multi-state efforts; Experience conducting analysis of the Colorado insurance market; Demonstrated experience reading, interpreting, and applying Colorado insurance statutes, regulations, and policies with a focus on health insurance; Demonstrated professional

• experience working with Medicare, including benefits, guidelines, and/or plans.

Required Competencies:The following knowledge, skills, abilities, and personal characteristics are required competencies and may be considered during the selection process (including examination and/or interview): Demonstrated written communication skills, including the ability to convey information to various stakeholders in a clear, accurate, and concise written manner; Demonstrated verbal communication skills, including the ability to effectively convey information to audiences in a concise manner; Demonstrated attention to detail; Demonstrated critical thinking and analytical skills, including having the ability to evaluate information in order to apply knowledge and to decide on the most appropriate course of action; Demonstrated prioritization skills, including planning, organizing tasks, and managing work assignments; Demonstrated time management skills, including the ability to multi-task to effectively manage competing and constantly changing priorities in order to meet tight deadlines; Demonstrated ability to understand and abide by workplace principles, practices and behaviors as internally identified and defined by the division and department; Demonstrated ability to read, understand, interpret, apply, and explain laws, rules, policies, and procedures; Sound judgment and the confidence to make decisions on a routine basis; Ability to travel independently, including work in-office, as required by business needs and scheduled by the supervisor; Integrity and high ethical standards; Accountability, reliability, including attendance; Ability to maintain confidential, controversial, or sensitive information; Self-starter, including the ability to work independently, learn new processes, utilize own knowledge and that of the supervisor, and complete work with minimal supervision; Demonstrated professional demeanor; Knowledge and understanding in the use of PC software applications including Microsoft Office (Access, Word, Excel, etc.), and Google Suite (Doc’s, Sheets, Slides, etc). Conditions of Employment:Candidates who fail to meet the conditions of employment will be removed from consideration. The successful passing of a reference check and/or, if required, a background check.

A reference check may include but is not limited to: contacting previous and current supervisors to verify employment and discuss performance, a review of the personnel file, a review of the performance record, a review of job-related public information, etc. The type of background check depends on the job duties of the position and can include a review of any criminal record, credit report, and/or driving record. Ability to travel independently, including work in-office, as required by business needs and scheduled by the supervisor.

This position requires the ability to travel up to 10% of the time, including staying over weekends when required; and the ability to transport equipment, including, but not limited to, laptop computers, printers, manuals, and supplies. Effective September 20, 2021, employees will be required to attest to and verify whether or not they are fully vaccinated for COVID-19. Employees who have not been fully vaccinated may be required to submit to serial testing in the future.

Upon hire, new employees will have three (3) business days to provide attestation to their status with proof of vaccination. Vaccinated employees must provide proof of vaccination. Note: Fully Vaccinated means two (2) weeks after a second dose in a two-dose series of the COVID-19 vaccine, such as the Pfizer or Moderna vaccine, or two (2) weeks after the single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine, as defined by the most recent State of Colorado’s Public Health Order and current guidance issued by the Colorado Department of Public Health & Environment.

Supplemental Information

PLEASE READ - Required Application Materials Interested individuals must submit the following online: 1.A completed State of Colorado Application(log-in to your current NeoGov account or create a NeoGov account to complete the online application). Note: Incomplete applications, including incomplete work history sections or "see résumé," "see attachment," or "see addendum" statements, will not be accepted in lieu of a completed application form. 2.A current email address on your application, as all communication pertaining to this position will be conducted via email.

Please set up your email to accept messages from info@governmentjobs.com and ‘@state.co.us’ addresses, and check your email often. Note: The department cannot guarantee the successful delivery of email, including incorrect filtering into junk mail folders. 3.A detailed cover letter, explaining how you meet the required competencies and how your accomplishments, qualifications, skills, areas of expertise, personal characteristics, etc. make you a good fit for this position; you may also attach additional documents that demonstrate this.

Comparative Analysis Process: Structured Application Review Part of, if not the entire, comparative analysis process for this position will involve a review of the information you submit in your application materials; Therefore, it is paramount that in the experience portion of your application and cover letter, you describe the extent to which you possess the education, experience, and competencies outlined in the job announcement as well as the required and/or preferred qualifications/competencies. You are also encouraged to attach additional documents to that effect.

Failure to include adequate information or follow instructions may affect your score and prevent you from competing in subsequent measures used to arrive at a top group of applicants. Part of the comparative analysis process and/or the interview process may be conducted through remote video conferencing (i.e. Google Meet, Zoom, etc.) Veterans’ Preference: Candidates who wish to assert Veterans’ Preference should attach a copy of their DD214 to their application.

Failure to do so will result in being denied Veterans Preference. PLEASE NOTE:Former State Personnel System employees who were disciplinarily terminated or resigned in lieu of termination must disclose this information on the application.

Colorado Revised Statutes require that all state employees be hired and promoted through competitive examination of merit and fitness. Failure to include the required information, failure to follow instructions, and/or failure to submit materials by the application deadline may result in your application not being considered for the position and may affect your score or inclusion in the final pool of qualified candidates. The State of Colorado believes that equity, diversity, and inclusion drive our success, and we encourage candidates from all identities, backgrounds, and abilities to apply. The State of Colorado is an equal opportunity employer committed to building inclusive, innovative work environments with employees who reflect our communities and enthusiastically serve them.

Therefore, in all aspects of the employment process, we provide employment opportunities to all qualified applicants without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity or expression, pregnancy, medical condition related to pregnancy, creed, ancestry, national origin, marital status, genetic information, or military status (with preference given to military veterans), or any other protected status in accordance with applicable law. ADAAA Accommodations: DORA is committed to the full inclusion of all qualified individuals. As part of this commitment, our agency will assist individuals who have a disability with any reasonable accommodation requests related to employment, including completing the application process, interviewing, completing any pre-employment testing, participating in the employee selection process, and/or to perform essential job functions where the requested accommodation does not impose an undue hardship.

If you have a disability and require reasonable accommodation to ensure you have a positive experience applying or interviewing for this position, please direct your inquiries to our ADAAA Coordinator, at dora_adacoordinator@state.co.us. Check out our excellent benefits package THIS ANNOUNCEMENT MAY BE USED TO FILL MULTIPLE VACANCIES

While a salary range is posted for this position, an eventual salary offer is determined by a comprehensive salary analysis, which considers multiple factors including but not limited to education and experience compared to others in the organization doing substantially similar work. Appeal Rights: If you receive notice that you have been eliminated from consideration for this position, you may file an appeal with the State Personnel Board or request a review by the State Personnel Director. An appeal or review must be submitted on the official appeal form, signed by you or your representative.

This form must be delivered to the State Personnel Board by email, US Mail, faxed or hand-delivered within ten (10) calendar days from your receipt of notice or acknowledgment of the department’s action. For more information about the appeals process, the official appeal form, and how to deliver it to the State Personnel Board go to spb.colorado.gov or refer to 4 Colorado Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov under Rules.

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