The SC Public Employee Benefit Authority (PEBA) is the administrator and co-trustee of retirement and insurance programs for over half a million active and retired public employees of the State of South Carolina and their dependents.Under limited supervision, this position serves as a critical liaison between Insurance Policy and external partners responsible for administering the state sponsored health and dental plans. This role coordinates and supports third party contractor relationships in a constructive manner, ensuring that service delivery aligns with PEBA’s strategic priorities, operational standards and program requirements. Acts as the primary point of contact for PEBA business units, manages day to day inquiries, escalations, and operational matters related to third party contractors. Offers a single consistent channel for communication to strengthen internal coordination, support timely issue resolution, and promote a unified, solution focused approach across the organization.
Job duties include:
- Overseeing relationships with third-party administrators for medical, behavioral health programs and, contractors for the State Health Plan's pharmacy, basic dental and dental plus program. Managing day-to-day operations, supporting contract administration, and monitoring program performance. Resolving day-to-day questions and issues in a collaborative manner with contractors. Ensuring benefit design, operations, and member services align with program goals and contractual requirements. Ensuring collaborative approach with the behavioral health contractor on coordinating benefits and care management
- Directing the coordination of contracted services provided under the Evidence-based Medicine contract. Ensuring that the contractor provides meaningful reporting that demonstrates the results of treatment improvement recommendations. Working with contractor to ensure that changes in applied treatment improvement recommendations to health care providers are implemented when suggested by contractor and agreed upon by PEBA.
- Supporting the review and revision of Requests for Proposals pertaining to health, pharmacy, behavioral health, dental and evidence-based medicine programs. Supporting the Director of Insurance Policy and the Director of Analytics Planning in executing strategic plans to introduce new healthcare initiatives with contractors.
A bachelor’s degree and at least 15 years of relevant experience including managing partnerships and contractor relationships. Working knowledge of healthcare issues and insurance concepts.
Ability to work collaboratively in a positive, constructive, solution-focused manner and demonstrate critical thinking as pertaining to health insurance issues and decision making. Knowledge of research and evaluation methods. Ability to collect, analyze and interpret data. Ability to initiate, develop and implement project plans. Ability to communicate clearly in both written and oral presentations. Ability to use computer software including knowledge of Microsoft Office Suite.In addition to 13 paid holidays, this position is eligible for comprehensive insurance programs, retirement plans, and a generous paid leave program.
