Fee For Service Operations & Quality Assurance Manager (Health Policy & Program Manager 2)

Job Description :

Do you have experience developing, implementing, and providing oversight of contracts, policies and programs at the community, state, and / or national level that promote equity and inclusion and reduce disparities?

Are you passionate about engaging diverse teams in designing and integrating quality assurance governance and oversight strategies to promote care coordination and improve health outcomes?

We look forward to hearing from you!

to view a Dashboard of all current recruitments for the Behavioral Health Division, Medicaid Division, and the Office of Data Strategy & Operations (which were previously all part of ).

The specific positions associated with this posting are listed under REQ-159368. The dashboard identifies the business area ( Section ) and Unit for each position and also provides a link to a position description to offer you greater context for the role.

Section 1 of the position description outlines Position Information, including Work Location and Supervisor Name. Section 3 outlines the Description of Duties.

This posting will be used to fill one (1) permanent, full-time position. This position is classified as Management Service and is not represented by a union.

Work Location : Salem / Marion or Portland / Multnomah; hybrid position

What you will do!

The primary purpose of the Fee For Service (FFS) Operations & Quality Assurance Manager position is to lead the design, policy development, implementation, and administration of programs under the Oregon Health Plan.

The position works closely with the state Medicaid director, deputy director, and Medicaid program executive team. This position leads a team of program analysts and administrative staff responsible for writing administrative rules, setting guidelines, and providing technical assistance.

In addition, this position develops community partnerships and designs contract oversight and quality assurance for the Medicaid program in collaboration with Medicaid leadership.

Specifically, this position is responsible for interpreting statewide policies and directives, as well as federal laws and regulations, to ensure the agency complies with Oregon's Medicaid and CHIP State Plans and Section 1115 Waiver of federal regulations that allows Oregon's unique application of Medicaid with the Oregon Health Plan design.

This position assigns duties, trains and supervises a team, and approves work outputs to ensure Medicaid programs operate efficiently, meet OHA’s mission / vision, and stay within federal and state regulatory bounds.

This position will advance OHA’s work to eliminate health inequalities by offering leadership and direction to assure all programs, policies, strategies, and initiatives implemented and influenced within this unit are health-based, equity-centered, and community-led.

OHA values service excellence, leadership, integrity, health equity and partnership and has a strategic goal to end all health inequities by 2030.

The OHA mission is helping people and communities achieve optimum physical, mental, and social well-being through partnership, prevention and access to quality, affordable health care.

OHA’s work is organized into three broad goals : Improve the lifelong health of all Oregonians, increase the quality, reliability, and availability of care for all Oregonians and lower or contain the cost of care so it is affordable to everyone.

What's in it for you?

Oregon Health Authority is a team of passionate individuals working to promote health across the lifespan of individuals, families, and communities.

We value and support unique perspectives using a trauma-informed approach and aim to reflect these values in our hiring practices, professional development, and workplace.

We offer exceptional benefits packages for you and your qualified family members, with very low monthly out-of-pocket costs.

Try this free virtual benefits counselor by clicking here :

• Paid Leave Days :
• 11 paid holidays each year
• 3 additional paid "Personal Business Days" each year
• 8 hours of paid sick leave accumulated every month
• Progressive vacation leave accrual with increases every 5 years
• Optional benefits include short-term disability, long-term disability, deferred compensation savings program, and flexible spending accounts for health care and childcare expenses.
• Click to learn more about State of Oregon benefits.

OHA values health equity, service excellence, integrity, leadership, partnership, innovation and transparency. OHA’s health equity definition is Oregon will have established a health system that creates health equity when all people can reach their full potential and well-being and are not disadvantaged by their race, ethnicity, language, disability, age, gender, gender identity, sexual orientation, social class, intersections among these communities or identities, or other socially determined circumstances.

Achieving health equity requires the ongoing collaboration of all regions and sectors of the state, including tribal governments to address : the equitable distribution or redistributing of resources and power;

and recognizing, reconciling, and rectifying historical and contemporary injustices. OHA’s 10-year goal is to eliminate health inequities.

Click , t o learn more about OHA’s mission, vision and core values.

WHAT WE ARE LOOKING FOR :

Minimum Qualifications

Six years of supervision, management, or progressively related experience; OR three years of related experience and a Bachelor’s degree in a related field.

Desired Attributes

• Experience in advancing health equity, including effective delivery of culturally responsive and inclusive services, evidence of ongoing development of personal cultural awareness and humility, and knowledge of social determinants of health and their impacts on health outcomes.
• Experience developing, implementing policies and programs at the community, state, and / or national level that promote equity and inclusion and address systemic health disparities, with an emphasis on integrating the voice of consumers with lived experience.
• Experience in collaborating with diverse populations most harmed by social injustice and inequities; demonstrated ability to build and steward positive, collaborative and partnership-based relationships with diverse community groups including communities of color, immigrant groups, the disability and neurodivergent communities, veterans, older adults, individuals identifying as LGBTQIA2S+ and other communities that have been traditionally marginalized.
• Specific knowledge of Oregon Administrative Rules and Oregon Revised Statutes, other applicable regulations, and program requirements.
• Knowledge of health services delivery systems, particularly the Oregon Health Plan / Medicaid administration in Oregon, and experience in working with Community Mental Health Programs, Behavioral Health Service Providers, Coordinated Care Organizations or other managed care entities and their leadership to guide operations and policies.
• Knowledge and experience with Centers for Medicare and Medicaid Services (CMS) waiver and demonstration projects.
• Experience interpreting, applying and enforcing relevant federal and state Medicaid laws and regulations, including Medicaid Managed Care regulations.
• Knowledge and experience of the legislative process and government finance, specifically reviewing, interpreting and analyzing legislative concepts and legislative bills.
• Knowledge of Oregon's Behavioral Health System and relational landscape of key partners, providers, community based organizations, peer delivered services, and advocacy groups.
• Knowledge about contracts / interagency agreement administration, procurement, and project management within the context of Oregon state government (e.

g. OHA / ODHS) or other complex health services delivery organizations.

• Experience in financial and budget management, tracking and oversight for larger scale efforts or program / team accountability.
• Familiarity with varying funding streams for statewide and community investment and value-based payment mechanisms.
• Knowledge of medical service delivery system billing practices.
• Specific knowledge of business and management principles involved in strategic planning, resource allocation, leadership technique, iterative design, and improvement science;

including experience in effectively managing teams and fostering a trusting team culture.

• Ability to provide organizational leadership to support inter-and cross-agency collaboration and systems-wide changes that facilitate advocacy, equity, and client-centered policies and solutions.
• Demonstrated project management experience, including ability to effectively manage multiple project timelines, contracts, plans, and deliverables.
• Experience and knowledge of quality improvement methodologies and metrics within the context of health policy, health systems, and health care delivery settings.
• Experience with health outcomes research, healthcare delivery systems research, or experience using healthcare expenditure, utilization, and quality assurance data to manage, plan, and evaluate the cost effectiveness, access, and quality of medical programs.
• Strong communication skills across a variety of forms that demonstrate the ability to facilitate appreciative inquiry, foster trust and transparency, and promote human-centered change management.
• Experience communicating qualitative and quantitative information, verbal and written, that are accessible to and understood by audiences with different levels of comprehension or interest and that are culturally responsive, inclusive, and appropriate.
• Ability to navigate complex relationships; ability to demonstrate collaborative problem-solving skills, consensus-building and solution driven approaches.
• Ability to demonstrate successful meeting facilitation with variety of internal and external partners including program-policy-fiscal staff, community members, community groups, government officials and legislators.
• Advanced Microsoft Excel, Word, PowerPoint and Outlook skillset; and skilled use of collaboration tools such as Microsoft Teams, SharePoint, and Smartsheet.
11 days ago