Medical Assistance Program Specialist 3 (MAPS3/MPD) Non-Permanent
Full Time
Olympia, WA
Posted
Job description
Description
Medical Assistance Program Specialist 3 (MAPS3/MPD) Non-Permanent
71092495
Anticipated end date June 30, 2023
Per Governor Inslee’s Proclamation 21-14 state employees must be fully vaccinated. Your vaccine status will be verified upon acceptance of a contingent job offer. Please note, medical or religious accommodation may be available once an offer of employment is made.
About the division:
The Mission of the Medicaid Programs Division (MPD) in the Health Care Authority (HCA) is to provide high quality administrative services to assist in the purchase and delivery of medical assistance program services to clients and members. MPD works 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.
About the position:
This Medical Assistance Program Specialist 3 (MAPS3) is the subject matter expert (SME) for the Alien Emergency Medical (AEM) program administering and managing contracts and contract compliance to ensure access to medical care for all eligible Washington state citizens and Medicaid equivalent health care coverage to uninsured populations, regardless of immigration status. This position also provides expert technical assistance and updates to the Managed Care Organization (MCO) staff and acts as a liaison for MCO and Apple Health Expansion (AHE) plan benefits, contracting models, and recommends and implements changes to ProviderOne to support program operations. As the program continues to expand, oversight and expertise on service delivery models for funds allocated through this contract will be essential to ensuring accountability and success for AHE covered services including state only fund allocation, bailing and payment processes, Alien Emergency Medical (AEM) programs, and State Waiver activities. 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 of and develop relationships with local health care providers, Managed Care Organizations, Hospitals, Department of Social and Health Services, and other state or federal agencies to oversee management of these uninsured individuals. This position will also recommends and implements policy changes to improve access to health care services for uninsured residents of Washington.
This position is eligible to telework and is typically not required to report on-site.
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 and coordinated health care services.
- Serves as the Agency subject matter expert for the Alien Emergency Medical program overseeing development of contract language, 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.
- Daily management of Managed Care contracts serving Medicaid, Children’s Health Insurance Program, and SSI Blind and Disabled enrollees.
- Provides expert direct oversight of one or more managed care contracts sections including monitoring of service delivery to ensure high quality and coordinated health care services.
- Ensures contractor compliance with federal and state regulations, including Centers for Medicare and Medicaid requirements related to service delivery.
- Participate in development and implementation of updated contracts for IMC, IFC, and Wraparound services.
- As an expert in the development of accurate, contract language, 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.
- Provide high level, expert assistance to other HCA staff as needed to implement health care reform programs.
Qualifications
Required qualifications:
- A 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
- Two (2) years as a Medical Assistance Program Specialist 2 (MAPS2)
(Note: Additional years of experience may be substituted for the required education on a year-for-year basis.)
Required Skills and Abilities:
Ability to:
- Analyze and resolve complex problems.
- Independently manage competing timelines to meet critical deadlines and handle multiple projects at a time.
- Write clear, narrative, analytical reports.
- Facilitate timely communications and interchange between diverse groups of internal and external departments, agencies, and Contractors.
- Facilitate large meetings with state and Contractor participants.
- Maintain the highest standards of personal/professional and ethical conduct.
- Model behaviors that encourage an open, inclusive work environment.
- Share appropriate information internally and externally.
- Excellent verbal and written communication skills, including technical and non-technical report writing and oral presentations with a wide variety of audiences including community members, provider groups, clients, and client advocates.
- Excellent computer software literacy for document development and tracking.
Preferred qualifications:
- At least 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 of 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.
- 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.
Supplemental Information
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 and attach:
A cover letter that specifically addresses how you meet the qualifications for this position- Current resume
- Three professional references
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:
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:
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!
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. 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 Angelic Matthews at angelic.matthews@hca.wa.gov
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