See ES Benefits Technician.

Supervises Benefits Specialists, coordinates and directs the activities of a unit providing insurance benefits services to claimant/customer and employer.

Working under general direction positions are responsible for the delivery of insurance benefits services. Supervises staff and manages a unit of ES Benefits Specialists.

Provides guidance to staff to ensure the delivery of services and monitors quality, performance and productivity;

Answers highly complex questions and provides advise to claimant/customer and employer on insurance benefits laws, policies and procedures;

Researches and identifies complex issues or facts to respond to claimant/customer and employer inquiries and program complaints;

Supervises a team of ES Benefits Specialists; performs timesheet recording, tracking and approving leave; writes performance expectations and evaluates staff performance, provides regular feedback to staff; interviews and recommends new hires for positions within unit;

Manages program requirements for assigned unit;

Reviews decisions, advises staff and determines if further action is needed;

Provides expert technical assistance, training and guidance to staff regarding the Department’s insurance benefits laws, policies, processes and procedures;

Resolves personnel issues using established processes;

Coordinates with manager and HR staff to resolve escalated personnel issues;

Monitors staff workload, productivity and work product quality;

Leads and coordinates process improvement efforts for internal and agency wide teams;

Performs the duties of the lower levels in the series;

Performs other duties as required.

Knowledge of: insurance benefits service programs, applicable state and federal laws, regulations and policies, principles, problems, and practices of insurance benefits program administration; principles of individual and group behavior, social behavior, social and economic conditions, and their effects upon individuals; office procedures and practices; supervising subordinate employees.

Ability to: make independent conclusions and decisions; evaluate and recommend changes to insurance benefits program management; work cooperatively with staff, members of the public and with co-workers; practice tact, courtesy and discretion; accurately document, listen, observe, communicate, confront and engage in problem solving and conflict resolution; convey interest and concern to clients requesting information or assistance with problems related to insurance benefits programs and services; express ideas clearly; direct and assist others in interpretation and analysis of data; supervise and train staff.

There may be instances where individual positions must have additional licenses or certification. It is the employer’s responsibility to ensure the appropriate licenses/certifications are obtained for each position.

Persons legally authorized to work in the U.S. under federal law, including Deferred Action for Childhood Arrivals recipients, are eligible for employment unless prohibited by other state or federal law.

One year as a ES Benefits Specialist 3.

OR

A Bachelor’s degree in a health or social science, public administration or a related field and three years of experience examining and/or processing loan applications, medical insurance or rehabilitation claims, insurance claims, collection of insurance premiums, tax collection or providing staff support in financial eligibility determination.

OR

A Master’s degree in a health or social science, public administration or a related field and two years of experience examining and/or processing loan applications, medical insurance or rehabilitation claims, insurance claims, collection of insurance premiums, tax collection or providing staff support in financial eligibility determination.

OR

A combination of education and relevant experience.

OR

One year of experience equivalent to the ES Benefits Specialist 3 with another state that administers insurance benefits programs.

AND

One year of supervisory experience.

Establishment, adopted June 22, 2023, effective July 1, 2023.

Revised Legal Requirements; effective June 6, 2024, due to adopted legislative action.