Director of Health Complaints and External Appeals (Director Financial Services Programs 3, NS)
: Job Details :

Duties Description Preferred Qualifications•A Bachelor's Degree and eight (8) years of relevant experience, three (3) years of which must have been as a managerial level.Appointment method:This is an appointment to a position in the exempt jurisdictional class. As such, the incumbent of this position would serve at the pleasure of the appointing authority.Minimum Qualifications The New York State Department of Financial Services seeks to build an equitable, transparent, and resilient financial system that benefits individuals and supports business. Through engagement, data-driven regulation and policy, and operational excellence, the Department and its employees are responsible for empowering consumers and protecting them from financial harm; ensuring the health of the entities we regulate; driving economic growth in New York through responsible innovation; and preserving the stability of the global financial system.The Department of Financial Services is seeking candidates for the position of Director of Health Complaints and External Appeals in Consumer Protection and Financial Enforcement Division (CPFED). The incumbent of this position be a member of the Consumer Assistance Unit (CAU) Management Team and will provide daily oversight of three Units within CAU: the Health Unit, the Consumer Representative Unit, and the Processing Unit. Duties include, but are not limited to:•Oversees the daily operations of the Health Unit within CAU, which includes two major consumer protection programs: External Appeal (EA), and Independent Dispute Resolution (IDR), as well as complaints against regulated health insurers:o Manages a staff of 28 professional examiners and supervising examiners, as well as 9 paralegals;o Manages investigations and resolution of matters that are escalated;o Processes and resolves complaints, external appeals and IDR's;o Manages contractual relationships with CAU vendors used for EA and IDR processes, as well as relationships with regulated health insurance companies;•Oversees the daily operations of the Consumer Representative Unit within CAU:o Manages a staff of a supervising examiner and 6 consumer representatives;o Processes direct phone calls and emails from consumers, health care providers and various other constituents;•Oversees the daily operations of the Processing Unit within CAU, which provides support for all CAU functions (complaints, EA and IDR) as well as complaints in other business units (Mortgage Assistance Unit, Producer Investigation Unit, Property No-Fault Unit, Excess Lines Unit and Student Protection Unit):o Manages a staff of 15 paraprofessional and clerical workers;o Manages daily operations of support staff who handle daily incoming and outgoing mail, complaint set up, external appeal process (timing and handling);•Liaises with the Statewide Call Center to determine tracks and trends, while also ensuring updated information is conveyed to Call Center for use with New York consumers, including updates on enforcement action, new legislation, disaster resources, or any other helpful information for consumers;•Acts as a project manager for CAU IT initiatives;•Liaises with the Administration/Office of Financial Management for CAU contract matters; and•Other duties as assigned.Additional Comments Positions located within the New York City metropolitan area, as well as Suffolk, Nassau, Rockland, and Westchester Counties, are also eligible to receive an additional $3,400 annual downstate adjustment.Appointment Status: This is an appointment to a position in the exempt jurisdictional class.Appointment to this position is pending Governor Appointment's Office and Division of Budget approval.Some positions may require additional credentials or a background check to verify your identity.Name Nathan Keiper Telephone Fax 518-###-#### Email Address ...@DFS.ny.gov AddressStreet 1 Commerce plaza 3rd Floor City Albany State NY Zip Code 12257 Notes on Applying To Apply: Interested qualified candidates must submit a resume and letter of interest no later than February 11, 2025 to the email address listed below. Please include Vacancy ID in the subject line of your email to ensure receipt of your application. Email submissions are preferred.Please be advised that the New York State Department of Financial Services does not offer sponsorship for employment visas.Nate KeiperBox DFSP3-DHCEA-10103New York State Department of Financial ServicesOffice of Human Resources Management One Commerce Plaza, Suite 301Albany, NY 12257Email: ...@dfs.ny.govFax: (518) ###-####All candidates that apply may not be scheduled for an interview.Public Service Loan ForgivenessEmployment with New York State qualifies an individual for Public Service Loan Forgiveness (PSLF). This program forgives the remaining balance on any Direct Student Loans after you have made 120 qualifying monthly payments while working full-time for a U.S. federal, state, local, or tribal government or not-for-profit organization. To learn more about the program and whether you would qualify, please visit: AMERICANS WITH DISABILITIES ACT: REASONABLE ACCOMMODATIONSUnder the Americans with Disabilities Act (ADA), the Department of Financial Services is required to provide reasonable accommodation for known physical or mental limitations of an otherwise qualified applicant with a disability if an accommodation would enable the applicant to perform the essential functions of the job. If the accommodation would constitute an undue hardship on the operations of the agency, the agency is not required to provide it.All people with disabilities are encouraged to apply to all jobs for which they meet the minimum qualifications.