MCHCP Departments

Advises the Board on all matters pertaining to the Plan.
Maintains knowledge of health care trends and their impact on MCHCP.
Coordinates the development, evaluation, and award of Requests for Proposal (RFPs) and new products.
Assists in the negotiation and execution of contracts.
Follows applicable new state and federal regulations to ensure MCHCP’s compliance.
Manages the organization on a daily basis.

Assists in the development and evaluation/analysis of Requests for proposals (RFPs) for health plan vendors.
Oversees and evaluates the performance of HMO, PPO, PBM, and Wellness and Disease Management vendors who are awarded contracts by MCHCP.
Monitors and evaluates various provider issues including network development by contractors, provider turnover, and provider performance.
Serves as a liaison between members and contractors on a wide range of medical situations and the interpretation of benefits.

Recognizes the need to function as a consistent member advocate for state employees as well as public entity employees.
Ensures that the mission of MCHCP is achieved by overseeing all aspects of member related operations across several departments.
Oversees the Directors of Marketing, Customer Support, and Member Records who have responsibility for the daily management and execution of departmental goals.

Provides customer service and communications support for MCHCP.
Responds to concerns and questions regarding member benefits and eligibility.
Provides educational and informational materials to members.
Conducts statewide open enrollment meetings, new employee orientations, active employee and pre-retirement seminars, and human resource/payroll workshops.
Assigns account representatives to individual state agencies and participating public entities.
Serves as a liaison between members, human resource/payroll representatives, and the contracted health care providers for MCHCP.
Attends and participates in Association of Retired Missouri State Employees (ARMSE) meetings, employee/health fairs, and other meetings as requested.
Informs and communicates with Missouri local governments about health insurance plans available through MCHCP.
Conducts meetings and provides presentations and materials to eligible local governments considering participation in plans offered through MCHCP.
Trains and retains services of contracted producers.

Maintains financial records of programs administered by MCHCP.
Prepares the Comprehensive Annual Financial Report (CAFR).
Performs all purchasing functions for MCHCP.
Coordinates banking services.
Interfaces with the Office of Administration, accounting and budgeting departments, various payroll/personnel officers of state departments, accounting offices of health maintenance organizations, consultants, actuaries, banks, and the IRS.

Directs all aspects of the MCHCP personnel program.
Interviews and selects employees.
Establishes and maintains a fair compensation system.
Conducts new employee orientations and handles other employment and staffing related issues.
Writes and maintains job descriptions in a position classification plan.
Handles training and development of workforce, wage and hour issues, and worker’s compensation reporting.
Writes and interprets personnel policies and procedures while ensuring compliance with all federal, state, and local personnel laws.
Ensures fair and equitable treatment of all employees as well as those candidates seeking employment.

Provides technology services to all MCHCP operation areas.
Monitors internal operation controls and external public access to data in accordance with established government guidelines and regulations while implementing sound business practices and proven industry standards.
Strives to improve the quality of member services by enhancing strategic partnerships, data exchange, internal process efficiency, information awareness, and Web-based applications.
Ensures the continued availability and integrity of all data processes that support day-to-day operations and long-term goals.
Maintains information security and operational continuity.
Seeks new technology-based solutions by leveraging current resources to improve operational efficiency, communications, and overall member value.
Oversees Receiving Services section which is responsible for mail room activities, shipping and receiving, and minor building maintenance and repairs.

Represents and advises the Board of Trustees.
Drafts proposed legislation and regulations.
Analyzes legislation.
Represents MCHCP, or coordinates representation through outside counsel, in litigation matters.
Prepares and interprets legal documents, including all contracts.
Serves as Privacy Officer to ensure compliance with HIPAA.
Mitigates risk of loss from error, waste, and misconduct and ensures the use of sound business practices.

Maintains enrollment records for eligible members.
Administers coverage for retirees, survivors, members on leave-of-absence, those eligible for long-term disability, vested members who leave employment, and COBRA coverage under Federal guidelines.
Ensures that public entity contributions, state contributions, and member contributions are appropriately applied to members’ accounts.