Uniform Medical Plan (Ump) Contract Analyst (Wms1/Erb)

Salary : $64,284.00 - $90,024.00 Annually
Location : Thurston County - Olympia, WA
Job Type: Full Time - Permanent
Remote Employment: Remote Optional
Job Number: 2024-02924
Department: Health Care Authority
Division: ERB
Opening Date: 03/04/2024
Closing Date: 3/26/2024 11:59 PM Pacific
Description
Uniform Medical Plan (UMP) Contract Analyst (WMS1/ERB)
71090283
The deadline for submission has been extended to 3/26/24 at 11:59pm.
Join our team as a Uniform Medical Plan (UMP) Pharmacy Contract Analyst, where you'll play a crucial role in managing the daily operations of our largest pharmacy plan, covering about 400,000 enrollees under the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) Programs. You'll provide strategic advice to Executive Management on initiatives, contracts, and policies, with a focus on achieving budgetary goals and enhancing access, quality, and cost-effectiveness for UMP enrollees. This position offers the opportunity to lead in executive-level decision-making, manage vendor relationships, and contribute to statewide projects aimed at improving healthcare access and policy development.
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 Health Care Authority (HCA) oversees healthcare insurance for over 2.2 million Washington residents and 725,000 public and school employees, retirees, and their families, spending $5 billion annually. Through programs like the School Employees Benefits Board (SEBB) and Public Employees Benefits Board (PEBB), HCA ensures access to healthcare for all, promoting safe and effective use of technology and prescription drugs. As part of its mission for a healthier Washington, HCA focuses on innovative policies and strategies, including this position within the ERB Division, aligning with the Governor's initiatives and strategic priorities to enhance health outcomes for enrollees. Specifically, the Uniform Medical Plan (UMP) Contract analyst oversees operations to meet budgetary goals and improve access, quality, and cost-effectiveness for the individuals covered under the UMP pharmacy benefit.
About the position:
As a direct report to the UMP TPA Manager, this role assumes a pivotal position in executive leadership, supporting the Senior Pharmacy Contract Manager in critical discussions with external entities, educational institutions, and the public. With a focus on cultivating robust relationships, the incumbent supports the Senior Pharmacy Contract Manager in providing oversight of contracted vendors to guarantee adherence to contractual obligations and sustain optimal performance levels. Integral responsibilities encompass drafting and reviewing proposals, analyzing vendor performance, and exploring innovative contracting options, particularly regarding Pharmacy Benefit Manager contracts. Furthermore, this position contributes to statewide initiatives concerning provider access, policy development, and program planning within the ERB Program framework.
This position is eligible to telework but is required to report on-site for quarterly meetings or other business needs. 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
As a support to the Senior Pharmacy Contract Manager, some of what you will do:

• Produce critical information for senior level management and other decision makers used in the process of developing strategies, identifying strategic priorities, and measuring program performance for the UMP pharmacy contract.
• Coordination and support of clinical and administrative programs, the fulfillment and project management of ad hoc requests for information, and detailed analyses for a wide variety of decision makers across the Health Care Authority related to the UMP contracts.
• Develop work orders for UMP to conduct market research, identify vendors, costs, and benefits of new services or products for PEBB and SEBB Program members primarily for Pharmacy Benefit Manager and other contracts as needed.
• Major outcomes include the implementation and management of programs, services, and benefit designs that meet cost and quality objectives of employee benefits and member health.
• Apply critical thinking skills to ensure accuracy of benefits design and member communications. Ability to identify erroneous language that could misrepresent the intent/meaning of written descriptions.
• Knowledge and understanding of federal and state mandates as they relate to the PEBB Program and SEBB Program.
• Cross train for other positions, roles, and responsibilities to serve as back up for key positions that manage the other accounts on the Portfolio Management and Monitoring team, such as the Third-Party Administrator, Accountable Care Program, and the Centers of Excellence Program.
• Apply advanced writing skills for the editing of certificates of coverage for all UMP plans, benefits briefing documents and presentations to executive-level leaders, both internally and externally. Presentation and meeting facilitation skills are required.
• Communicate and coordinate with key stakeholders, including advocacy groups, consumer groups, health plans, legislators or legislative staff, other states, national resources, etc. on purchasing related activities (e.g., benefit changes due to budgeted resources).

Qualifications
Required qualifications:
Bachelor's degree in a health care discipline, public health, public administration, business administration, or other health care education related to the work of health care benefits or health insurance administration
AND
Two years' experience in employer or health plan administration, health management programs, or negotiating, administering, or managing health plan contracts.
OR
Minimum of 6 years' experience in negotiating, administering, or managing contracts withat least 2 of the years in employer or health plan administration, health management programs, or negotiating, administering, or managing health plan contracts.
Preferred qualifications:

• Master's degree in a health care discipline, public health, public administration, business administration, or other health care field directly related to the work of health care benefits or health insurance administration.
• Experience contracting with and monitoring health plan vendors.
• Excellent verbal and written communication skills.

Advanced Technical and Professional Knowledge:

• Working knowledge of best practices in employee benefits administration.
• Working knowledge of health plan benefits utilization management, medical case management, and innovative methods to manage medical costs through control of overuse, misuse, and underuse of medical services.
• Advanced experience with Excel, PowerPoint, SharePoint, MS Project, and Visio.

Complex Project Design, Planning, and Management:

• Skills necessary to conduct data analysis, review data, and identify performance benchmarks for employee benefit sponsorship.
• Demonstrated ability to lead diverse work groups that deal with complex aspects of employee benefit sponsorship and health plan administration, including work groups that are composed of members with varied professional credentials, education, and experience.
• Demonstrated ability to design, implement, and manage the operations of large complex projects in an environment involving special interest stakeholders, legislators of both houses and political parties, public and private contractors, community collaboratives, and inter-governmental partnerships.

Communication and Interaction with Stakeholders:

• Group facilitation skills necessary to lead productive and efficient discussions.
• Communication skills necessary to effectively share knowledge with diverse audiences including co-workers, contractors, health care providers, public officials, SEBB Program enrollees, and special interest stakeholders to foster informed decision making.
• Ability to analyze and draft thorough bill analyses.

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
• A clear agency mission that drives our work and is person-centered
• A healthy work/life balance, including alternative/flexible schedules and mobile work options.
• A great total compensation and benefit package
• 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 Lisa Fleming at (360) 725-1723 or
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 expenses.
Other insurance coverage for auto, boat, home, and renter insurance is available through payroll deduction.
The Washington State Employee Assistance Progra...