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Eligibility Initiatives Manager (MA5/MCS)
Eligibility Initiatives Manager (MA5/MCS)State of Washington • Olympia, WA, US
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Eligibility Initiatives Manager (MA5 / MCS)

Eligibility Initiatives Manager (MA5 / MCS)

State of Washington • Olympia, WA, US
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Eligibility Initiatives Manager (MA5 / MCS)

71111200

This management analyst works on a strategic initiatives team to review and analyze evolving Apple Health (Medicaid) rules and policies being utilized to determine Apple Health eligibility in Washington state. This individual will be involved primarily in the coordination effort to transition information from a legacy system (ACES) to a modernized system (Washington Healthplanfinder). They will also contribute to unit initiatives, including facilitating work groups with state agencies, medical staff, and legal professional across the state. The ideal candidate will be highly organized and bring familiarity with Apple Health to this detail-focused position.

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 functions.

About the unit

Eligibility Policy Innovation and Community Support (EPICS), within the Medicaid Customer Service Division of Health Care Authority, consists of staff who represent the Director of the Health Care Authority and speak with the authority of the agency in communities across the state. Staff advise external stakeholders in community-based health organizations on behalf of the agency. Staff also evaluate and analyze federal statutes and regulations; they formulate state policy for Apple Health eligibility. Staff participate in long range strategic planning for Apple Health eligibility policy and service delivery while at the same time being responsive to short-term objectives.

About the position

This position reports to the Strategic Initiatives Manager and works as a part of the eligibility strategic initiatives team. This position is the subject matter expert in the review and analysis of alignment of operational, systems, and policy alignment as it relates to new initiative planning and policy implementation. Through use of project management and process improvement methodologies, this position provides expert analysis and recommendations to management, staff, and both internal and external partners on impacts of Apple Health eligibility operational and policy alignment to impacted business partners and cross agency workgroups.

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. HCA has currently suspended the ability to support out-of-state telework.

Some of what you will do :

  • Serve as the subject matter expert on Washington's Streamlining Eligibility rules technical workstreams.
  • Lead and facilitate internal, external, and cross-system workgroups as the subject matter expert in eligibility procedural, systems, and policy alignment as it relates to new eligibility and policy implementation.
  • Research and analyze new and / or existing Apple Health eligibility procedures, policies, and regulations for state and federal compliance.
  • Make recommendations for updates to impacted Apple Health eligibility systems based on analysis.
  • Coordinate rule review from ACES to the Eligibility Service and Washington Healthplanfinder to ensure procedural, systematic, and policy alignment.
  • Coordinate procedural updates with the EPICS outreach and training team for impacted staff, community assisters, and stakeholders.
  • Establish and coordinate eligibility operational changes and standards to Apple Health eligibility delivery systems with staff, internal and external partners, and stakeholders.
  • Manage multiple projects and assignments concurrently with a considerable degree of self-directed initiative.
  • Facilitate process improvement projects, workgroups, and meetings across the section and agency related to Apple Health eligibility policy, procedures, and workflows impacting Apple Health eligibility systems.
  • Provide policy managers with data and analysis to support policy development and programmatic maintenance.
  • Track eligibility data and coordinate requests through the data analysts within the section.
  • Resolve issues, respond to inquiries, and review legislation to ensure consistency with strategic, long-range plans.

Required qualifications :

Qualifying candidates will meet one of the following criteria options :

Option 1 :

  • Nine (9) years of experience as defined below.

    • Option 2 :

  • Associate degree with major study in health, social sciences, public administration, education, or closely related field, and
  • Seven (7) years of experience as defined below.

    • Option 3 :

  • Bachelor's degree with major study in health, social sciences, public administration, education, or closely related field, and
  • Five (5) years of experience as defined below.

    • Qualifying experience for the section above is defined as being in two or more of the following areas

  • Conducting research
  • Analyzing policies, laws, rules, or regulations
  • Policy development
  • Conducting business analysis and developing requirements
  • Leading business projects
  • Using process improvement methodologies (i.e. Lean, organizational change management)

    • Qualifying candidates will also have two (2) years of experience in one or more of the following areas :

  • Drafting Medicaid policy and procedures;
  • Researching Medicaid policy in other states;
  • Developing scenarios or strategies for long and short-term division planning;
  • Reviewing implementation of programs for compliance with legal requirements; and / or
  • Conducting analyses of Medicaid system, facts, statistics, and other relevant materials to resolve the questions or problems concerning Medicaid and state medical programs eligibility policy, legislative changes, and budgetary constraints.

    • Preferred qualifications :

  • Working in or alongside state government, resulting in a working knowledge of Washington State governmental structure and function of division, especially Medicaid policies, procedures, and services to ensure appropriate Medicaid services to participants of the division's programs.
  • Demonstrated experience leading diverse work groups that deal with complex aspects of health plan administration, including work groups that are composed of members with varied professional credentials, education, and experience.
  • Experience in project management, change management, and / or process improvement methodologies.
  • Demonstrated experience in the principles of management and organizational practice. This includes group process and problem-solving methodologies, conflict management, and negotiation skills.
  • Certification in project management, change management, and / or process improvement methodologies.
  • Applied knowledge and experience in computer skills, including knowledge and experience in ACES, Barcode, ProviderOne, Washington Healthplanfinder, and other related client data sources. Considerable experience with software programs including word processing, spreadsheets, databases, and flow charts.
  • Effective oral and written communications with clients, business community, and other professional / managerial groups including top agency management, public speaking; independent decision making; strong interpersonal skills; planning and project management; leadership.
  • Considerable working knowledge of state and federal laws, regulations and procedures as they relate to Medicaid, health care reform and delivery of medical programs.
  • Proficiency in the following areas : complex project design, planning and management.

    • 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 :

  • 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. 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 HCAjobs@hca.wa.gov. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Jake Nelko at jake.nelko@hca.wa.gov or 360.725.0945.

    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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    Manager Manager • Olympia, WA, US