Occupational Nurse Consultant (Onc/Mpd)-Project

Occupational Nurse Consultant (ONC/MPD) - Project

B389

This is a project position funded through June 30, 2025.

The purpose of this Occupational Nurse Consultant (ONC) is to serve as a Systems Coordinator to support House Bill (HB) 1580. HB1580 creates a system to support children in complex crisis situations who are inpatient and experiencing challenges to discharge or a Department of Children, Youth and Families (DCYF) dependent youth who is experiencing placement instability. HCA is looking for an RN who has experience working with children and youth with special needs. If you want to make real changes to our health care system while doing rewarding and meaningful work come join this passionate team!

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 Programs Division (MPD) in the Health Care Authority (HCA) is to provide high quality health care through innovative health policies and purchasing strategies which assist in the purchase and delivery of medical services to qualified Washington citizens. MPD staff works across the agency and between agencies (Department of Health, Department of Social and Health Services) and in partnership with health care providers and community stakeholders to develop and manage high-quality, evidence-based, health care programs and purchasing of services that enhance Apple Health clients' ability to access appropriate, quality health care. MPD is responsible for the implementation and oversight of Washington Apple Health delivery system, including Managed Care Organizations (MCO), Behavioral Health Administrative Services Organizations (BH-ASO) and Dual Eligible Special Needs Plan (DSNP) systems of care, serving over 2 million Washington residents in all 39 counties.

About the position:
This Occupational Nurse Consultant) collaborates regarding individual client situations with barriers to quality and timely care within the agency and system partners, such as the Governor's office, Developmental Disabilities Administration (DDA), Aging and Long-Term Support Administration (ALTSA), DCYF, MCOs, BH-ASOs, and other healthcare payors, and providers. This role is to identify, problem-solve, and work for resolution to system barriers to address similar client situations, which may include contract revisions, technical guidance to contractors and providers, stakeholder workgroup facilitation, and escalation of resource solutions to leadership. This position will use multiple avenues to identify individual and systems issues, including provider/client/contractor identification, systems partnering, and compliance review activities. This role participates in formal contractor oversight and monitoring activities. The position applies clinical judgment and analytical skills to assess and evaluate the quality of care and evaluate completeness of MCO and BH-ASO responses.

This position is eligible to telework but is required to report on-site for monthly meetings. 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.

Some of what you will do:

• Serve as the Systems Coordinator to provide clinical consultation and coordination for individual clients within the health care delivery system, including Apple Health managed care delivery system.
• Facilitate Rapid Response Team care coordination escalation processes and activities in collaboration with DCYF, DDA, OFM, and the Governor's office Team Coordinator to support reduction of barriers for children and youth who are inpatient and experiencing challenges to discharge or a DCYF dependent youth who is experiencing placement instability.
• Implement policies, procedures, and guidance to ensure access to cross-systems consultative bodies such as but not limited to Kids Mental Health WA teams and regional DDA consultants, the Youth and Young Adult Housing Resource Team (YYHART), Mobile Response Stabilization Teams, and MCOs
• Use available information, including individual client situations and system partner feedback to identify gaps and inform system planning and barriers identification. Serve as liaison to the Governor's Office Team Coordinator to ensure awareness of gaps and barriers for system planning and use and direction of flexible funding provided through the 1580 legislation.
• Serve as a Systems Coordinator for HB1580 to do systems planning and connections across system partners to ensure children in complex crisis their health care needs addressed in the delivery system.
• Consult, monitor, and review quality and timeliness of care and services provided to the population served within the delivery system, focusing on special populations.
• Provide oversight and direction to the delivery system to better serve individuals and efficiently use resources.
• Provide consultative expertise and recommendations regarding access to services Rapid Response Team involved children, youth and young adults to executive leadership.
• Collaborate to identify system barriers to quality and timely care with system partners, such as DDA, ALTSA, DCYF, MCOs, BH-ASOs, and providers.
  

Required qualifications:

AND

AND

Note: A master's degree in a health care field will substitute for one year of nursing experience.

Required Skills and Abilities:

• Facilitate timely communications and interchange between diverse groups of internal and external stakeholders, agencies, providers, and the public.
• Independently manage competing timelines to meet critical deadlines and handle multiple projects at a time.
• Analyze and resolve complex problems related to managed care delivery system.
• Collaborate across health care purchasing systems, build teams and work cooperatively with internal and external resources to support program development.
• Ability to write clear, narrative, analytical reports.
• Public relations and customer service skills, including conflict resolution and negotiation techniques.

Preferred qualifications:

• Two (2) years' experience in quality assurance and improvement principles and approaches.
• Experience in Medicaid managed care operations.
• Experience in contract management and accountability.

Working knowledge of:

• State and federal laws, policies, regulations and procedures on Medicaid and healthcare.
• Contract terms and processes.

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.

About HCA:
Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

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 Angel.Matthews@HCA.WA.GOV.

The Washington State Health Care Authority (HCA) is an E-Verify Employer. All applicants must have a legal right to work in the United States.

E-Verify® is a registered trademark of the U.S. Department of Homeland Security.

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Employment Type: Project (limited duration)