Apple Health Expansion Contract Manager (Maps3/Mpd)- Non-Permanent

Salary : $65,748.00 - $88,416.00 Annually
Location : Thurston County - Olympia, WA
Job Type: Full Time - Permanent
Remote Employment: Remote Optional
Job Number: 2024-00443
Department: Health Care Authority
Division: MPD
Opening Date: 01/16/2024
Closing Date: 1/30/2024 11:59 PM Pacific
Salary Information: The high end of the salary range, Step M is typically a longevity step
Description
Apple Health Expansion Contract Manager (MAPS3/MPD)- Non-Permanent
71092495
This is a non-permanent position funded through 6/30/2025.
All HCA employees will apply an equity lens to their work, which may include but is not limited to all analyses of core business and processes.
About the division:
The Mission of the Medicaid Program Division (MPD) is to work across the agency and in partnership with the health care community and community stakeholders to develop and manage high-quality, evidence-based health care programs and purchase services that enhance Medicaid enrollees' ability to access appropriate, quality health care. Staff in Managed Care Contracts and Compliance oversee a Statewide managed care program that provides services to Medicaid enrollees, including vulnerable SSI Blind and Disabled enrollees. The managed care program has approximately 1.8 million enrollees and 300,000 clients in Apple Health without a Managed Care Plan. Total expenditures per biennium for the Apple Health Managed Care Program are approximately $8 billion.
About the position:
This Medical Assistance Program Specialist 3 (MAPS3) will provide contract management for our Apple Health Expansion (AHE). Integrated Managed Care (IMC) and Wraparound contracts. Additionally, this position will research and respond to questions and issues related to these contracts. As a part of this role, the position will address client issues, develop contract language, respond to contract questions, provide oversight, and participate in review of contractor performance. This position is the subject matter expert (SME) for contract language and contract compliance which will ensure access to medical care for all eligible Washington citizens through the new Apple Health Expansion (AHE) that would provide Medicaid equivalent health care coverage to uninsured populations, regardless of immigration status. This position also provides expert technical assistance and updates to MCO staff and acts as liaison MCO and AHE plan benefits and contracting models and recommend and implement changes to ProviderOne to support program operations. The position reviews MCO and AHE materials and applies judgment and contractual knowledge to evaluate the outreach and marketing information according to Federal regulations and national standards. This position must have knowledge and develop relationships with local health care providers, Managed Care Organizations, Hospitals, DSHS, other state or federal agencies to oversee management of these uninsured individuals. This position will also recommend, promulgate, and implement policy changes to improve access to health care services for uninsured residents of the state of Washington. This position will also act as an assistant to the TEAMonitor Coordinator.
This position is eligible to telework and is typically not required to report on-site. The default assigned work location of all Health Care Authority (HCA) positions - both on-site and telework eligible positions - is within the State of Washington. Frequency of onsite work will vary based on business and operational needs. HCA may choose, but is not required, to support out-of-state telework on a case-by-case basis.
Duties
Some of what you will do:

• Daily management of AHE contracts serving Uninsured Washington State residents.
• Provides direct oversight and acts as the Agency subject matter expert of one or more contracts including monitoring of service delivery to ensure high quality, development of contract language, oversight, coordinated health care services, and federal compliance of contractors serving eligible clients.
• Ensure contractor compliance with federal and state regulations, including Centers for Medicare and Medicaid (CMS) requirements related to service delivery.
• Works with other divisions within HCA, such as, Pharmacy Point-of-Sale, Patient Review and Coordination (PRC), and Fee-for-service as those services coordinate with healthcare services provided by AHE.
• Acts as a liaison between managed care providers and other healthcare services, such as mental health and alcohol/substance abuse services.
• Participate in development and implementation of updated contracts for IMC, IFC, and Wraparound services.
• As an expert in the development of accurate, contract language, this position will assist the Contract development team in drafting, submitting, and receiving approval for all contract rewrites, amendments or initial drafts for IMC, IFC, and Wraparound contracts.

Qualifications
Required qualifications:

• Master's degree from an accredited college with a major study in public health, public administration, business administration, social work or closely related field.

AND

• Three (3) years supervisory or consultative experience in health services, social service, Medicaid, or social security disability programs.

OR

• One (1) year as a Medical Assistance Program Specialist 2

Note: Two (2) additional years of qualifying experience will substitute for the required master's degree provided a bachelor's degree from an accredited college has been achieved.
Preferred qualifications:

• At least two (2) years' experience in working with managed care operations, delivery systems, customer service activities and policy issues to ensure provision of high-quality care to Medical Assistance enrollees.
• At least two (2) years' experience in program development, implementation, and evaluation of managed care programs.
• Project management, including team facilitation and process improvement methods.
• At least four (4) years of experience working with diverse client populations with chronic illness, especially clients with behavioral health issues; including cultural competency in working with an ethnically diverse population.
• Knowledge of the structure and function of the various sub-divisions of the Health Care Authority and the Department of Social and Health Services, including experience in cross system collaboration, team building and aligning internal and external resources in support of program development to ensure the delivery of quality health care services to high-risk clients.
• At least two (2) years' experience in participating in and facilitating meetings and task forces involving internal and external stakeholders at the state and local level.
• At least (1) year of experience in operating the ProviderOne MMIS system and related data and information systems.
• Experience in data analysis and clear communication of complex data analysis results for multiple audiences; ability to analyze data related to contract performance and other issues relating to managed care contracts.
• Experience working with the Patient Review and Coordination Program or similar program type.

Competencies:

• Knowledge of state and federal laws, policies, regulations and procedures on Medicaid and healthcare both within and outside the Health Care Authority
• Familiarity with Apple Health and Care Coordination contract terms and processes.
• Communication skills, including written and oral presentations for a wide variety of audiences, community members, provider groups, clients and client advocates.
• Ability to facilitate timely communication and interchange between diverse groups of internal and external departments, agencies, and the public.
• Experience in technical and non-technical report writing for both low-literacy audiences and others, such as executive leadership, internal staff, contractors and interested stakeholders.
• Excellent public relations and customer service skills, including conflict resolution and negotiating techniques, especially relating to client/provider interactions.
• Creative problem-solving skills in working with medical, community services, and other health care providers in multiple systems that provide services for low-income clients.
• Ability to collaborate across systems, build teams, and work collaboratively with internal and external resources to support program development.

How to apply:
Only candidates who reflect the minimum qualifications on their NEOGOV profile will be considered. Failure to follow the application instructions below may lead to disqualification. To apply for this position, you will need to complete your profile which includes three professional references and attach:

• A cover letter that specifically addresses how you meet the qualifications for this position.
• Current resume.

To take advantage of veteran preference, please do the following:

• Attach a copy of your DD214 (Member 4 long-form copy), NGB 22, or USDVA signed verification of service letter.
• Please black out any PII (personally identifiable information) data such as social security numbers. Include your name as it appears on your application in careers.wa.gov.

Supplemental Information
About HCA:
The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.
HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, and the School Employees Benefits Board (SEBB) Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.
What we have to offer:

• Meaningful work with friendly co-workers who care about those we serve Voices of HCA
• A clear agency mission that drives our work and is person-centered HCA's Mission, Vision & Values
• A healthy work/life balance, including alternative/flexible schedules and mobile work options.
• A great total compensation and benefit package WA State Government Benefits
• A safe, pleasant workplace in a convenient location with restaurants, and shopping nearby.
• Tuition reimbursement
• And free parking!

Notes:
Prior to a new hire, a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment.
HCA is an equal opportunity employer. We value the importance of creating an environment in which all employees can feel respected, included, and empowered to bring unique ideas to the agency. HCA has five employee resource groups (ERGs). ERGs are voluntary, employee-led groups whose aim is to foster a diverse, inclusive workplace aligned with HCA's mission. Our diversity and inclusion efforts include embracing different cultures, backgrounds and viewpoints while fostering growth and advancement in the workplace. Women, racial and ethnic minorities, persons of disability, persons over 40 years of age, disabled and Vietnam era veterans, as well as people of all sexual orientations and gender identities are encouraged to apply. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Angel Matthews at
The Washington State Health Care Authority (HCA) is an . All applicants with a in the United States are encouraged to apply.
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More than Just a Paycheck!
Employee benefits are not just about the kind of services you get, they are also about how much you may have to pay out of pocket. Washington State offers one of the most competitive benefits packages in the nation.
We understand that your life revolves around more than just your career. Like everyone, your first priority is ensuring that you and your family will maintain health and financial security. That's why choice is a key component of our benefits package. We have a selection of health and retirement plans, paid leave, staff training and other compensation benefits that you can mix and match to meet your current and future needs.
Read about our benefits:
The following information describes typical benefits available for full-time employees who are expected to work more than six months. Actual benefits may vary by appointment type or be prorated for other than full-time work (e.g. part-time); view the job posting for benefits details for job types other than full-time.
Note: If the position offers benefits which differ from the following, the job posting should include the specific benefits.
Insurance Benefits
Employees and their families are covered by medical (including vision), dental and basic life insurance. There are multiple medical plans with affordable monthly premiums that offer coverage throughout the state.
Staff are eligible to enroll each year in a medical flexible spending account which enables them to use tax-deferred dollars toward their health care expenses. Employees are also covered by basic life and long-term disability insurance, with the option to purchase additional coverage amounts.
To view premium rates, coverage choice in your area and how to enroll, please visit the Public Employees Benefits Board (PEBB) website. The Washington Wellness program from the Health Care Authority works with PEBB to support our workplace wellness programs.
Dependent care assistance allows the employee to save pre-tax dollars for a child or elder care ex...