BHASO TEAMonitor Coordinator (HCPS/MPD)
71062450
This opportunity is internal and available to current HCA employees only.
This position coordinates annual compliance reviews for Behavioral Health Administrative Services Organizations (BH-ASO). This process includes subject matter experts and contractors, requiring a candidate with strong organizational skills to ensure these audits are completed on federally-mandated timelines. If you are in search of an opportunity to use your familiarity with Medicaid systems in a compliance- and process-focused position, this may be the opportunity for you!
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 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 health care services to qualified Washington citizens. MPD staff work across the agency and between agencies (Department of Health, Department of Social and Health Services, etc.) 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 clients' ability to access appropriate, quality health care.
About the position:
The purpose of this position is to provide a coordinated monitoring effort as a member of the team that performs federally required oversight of HCA-contracted Managed Care Organizations (MCOs) and contractual compliance monitoring of the BH-ASOs (collectively referred to as Contractors). This position uses project management and group facilitation to perform compliance reviews of contractually required topical areas (e.g., credentialing, grievances, subcontracts) as well as non-clinical file reviews of individual client and provider services. The position reviews MCO and BH-ASO materials and applies judgment and contractual knowledge to evaluate the completeness of information according to federal regulations and national standards.
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. This position reports to Olympia, WA. Frequency of onsite work will vary based on business and operational needs. All agency employees are required to report on-site in Olympia on their first and last days of employment to pick up and return state-issued equipment, regardless of telework status or location.
Some of what you will do:
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Coordinate annual formal monitoring and oversight of regional BH-ASOs according to contractual requirements, Department of Enterprise Services (DES) contract management standards, and federal block grant requirements.
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Support development and revision of documentation tools, guidelines, file review checklists, correspondence, and report formats.
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Support development of work tools to facilitate consistency of the monitoring review process.
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Coordinate annual review monitoring of each contracted BH-ASO.
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Coordinate annual virtual visits to each contracted BH-ASO.
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Assign and plan the work of Medicaid Compliance Review staff with other subject matter experts within the agency.
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Perform analysis and interpretation of contract monitoring results. Recommend needed improvement in programs, policies, and contract.
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Serve as support to TEAMonitor Coordinator in MCO TEAMonitor activities, including ensuring contractor compliance with federal and state regulations and Centers for Medicare and Medicaid Services (CMS) requirements.
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Serve as program specialist for annual formal monitoring and oversight of federally required monitoring of MCOs.
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Attend HCA/Contractor monthly meetings to inform monitoring activity changes and communicate key information.
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Recommend and support implementation of changes in HCA monitoring process to promote administrative simplification and transparency and to increase efficiency for agency and contractor staff.
Required qualifications:
Qualifying candidates will meet one of the following criteria options:
Option 1:
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Master’s degree in public health, public administration, business administration, social work, or closely related field and
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Two (2) years of supervisory or consultative experience in health services, social service, Medicaid, behavioral health, or other healthcare programs.
Option 2:
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Bachelor’s degree in public health, public administration, business administration, social work, or closely related field and
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Four (4) years of supervisory or consultative experience in health services, social service, Medicaid, behavioral health, or other healthcare programs.
Option 3:
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Associate degree in public health, public administration, business administration, social work, or closely related field and
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Six (6) years of supervisory or consultative experience in health services, social service, Medicaid, behavioral health, or other healthcare programs.
Option 4:
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Eight (8) years of supervisory or consultative experience in health services, social service, Medicaid, behavioral health, or other healthcare programs.
Option 5:
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One year as a Health Care Program Consultant.
Required competencies:
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The ability to take action to learn and grow.
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The ability to take action to meet the needs of others.
Preferred qualifications:
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Two (2) years of experience as a Health Care Program Specialist or comparable experience working in Medicaid or commercial insurance program.
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Experience in Medicaid managed care operations.
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Experience in contract management and accountability.
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Ability to:
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Work effectively with other HCA staff, providers, and other affected parties to develop and evaluate programs and analyze and resolve complex problems related to managed care programs.
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Collaborate across systems, build teams, and work cooperatively with internal and external resources for successful program management and development.
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Analyze data related to contract performance and other issues relating to the managed care contracts.
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Public relations and customer service skills, including conflict resolution and negotiating techniques.
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 in separate files:
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A cover letter that specifically addresses how you meet the qualifications for this position
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Current resume
To take advantage of veteran preference, please do the following:
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Attach a copy of your DD214 (Member 4 long-form copy), NGB 22, or USDVA signed verification of service letter.
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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:
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Meaningful work with friendly co-workers who care about those we serve Voices of HCA
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A clear agency mission that drives our work and is person-centered HCA's Mission, Vision & Values
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A healthy work/life balance, including alternative/flexible schedules and mobile work options.
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A great total compensation and benefit package WA State Government Benefits
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A safe, pleasant workplace in a convenient location with restaurants, and shopping nearby.
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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. Studies have shown women, racial and ethnic minorities, and persons of disability are less likely to apply for jobs unless they feel they meet every qualification as described in a job description. Persons over 40 years of age, disabled and Vietnam era veterans, as well as people of all sexual orientations and gender identities are also encouraged to apply. If you have any questions about the required qualifications or how your experience relates to them, please contact us at [email protected]. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Jake Nelko at 360-725-0945 or [email protected].
The Washington State Health Care Authority (HCA) is an E-Verify employer. All applicants with a legal right to work in the United States are encouraged to apply.
E-Verify® is a registered trademark of the U.S. Department of Homeland Security.
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