Health Home / 1915(i) Program Specialist (HCPS/MPD)

Full Job Description

Health Home / 1915(i) Program Specialist (HCPS/MPD)

71028765

Are you in search of an opportunity to support innovative public health programs?

The Health Care Authority is in search of a program specialist to provide consultation and coordination for Health Home and 1915(i) Medicaid programs.

The ideal candidate will be solution-focused and able to quickly learn new programs and concepts.

Job seekers interested in bringing their flexibility and problem solving skills to unique programs that interact with several parts of service delivery and care coordination are encouraged to apply!

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 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 approximately 1.9 million Washington citizens.

About the position:

This position reports to a Unit Supervisor in the Strategic Design and Program Oversight section and will provide program management for our 1915(i) Community Behavioral Health Support Services (CBHS) and Dual Special Needs Plans Health Homes.

This position provides consultative expertise on this program to top level managers within the Health Care Authority and to other state agency staff, Managed Care Organizations (MCOs) and providers.

This position supports HCA’s mission by leading a program that is innovative in its array of services and in the authorizing environment, by utilizing a new Centers for Medicare & Medicaid Services (CMS) authority type.

This position is eligible to telework but may be required to attend occasional on-site meetings to support 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.

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.

Requirements

Some of what you will do:

Act as a Program Specialist for the Statewide Community Behavioral Health Support Services 1915(i) Program

• Collaborates with the CBHS Program Manager on the oversight and compliance with policies and procedures for the statewide Community Behavioral Health Support Services Program, funded through a Medicaid 1915(i) waiver
• Provides reviews of 1915i service referrals using program knowledge and research.
• Coordinates with MCOs and DSHS to resolve eligibility issues and support medical records reviews.
• Represents the agency with external stakeholders in communications around eligibility for services as well as coordinating the implementation of guides, manuals, and WACs.
• Coordinates with MCOs and the Adult Family Home Council (AFHC) clearinghouse on the use of ProviderOne or other systems related to eligibility and payments.
• Coordinates the oversight and contract management of the CBHS Clearinghouse for Adult Family Homes.
• Prepares and assists in the preparation of policy and contract documents for internal discussion, presentation to executive leadership, and communication with stakeholders

Act as Program Specialist for Dual Special Needs Plan (DSNP) Health Home

• Partners with the DSNP subject matter expert (SME) and Health Homes SME on 1945 of the Social Security Act as it relates to Health Home services.
• Collaborates with the Medicare Advantage SME in the ongoing efforts to advance Medicare-Medicaid integration consistent with federal expectations.
• Provides support to the agency’s SME supporting oversight of one or more State Medicaid Agency Contracts (SMAC) including monitoring of service delivery.

Qualifications

Required qualifications:

Qualifying candidates will meet one of the following criteria options:

Option 1:

• Master’s degree with major study in public health, behavioral health, public administration, business administration, social work, or closely related field and
• Two (2) years of consultative or supervisory experience in health services, social services, Medicaid, behavioral health, or other health care programs.

Option 2:

• Bachelor’s degree with major study in public health, behavioral health, public administration, business administration, social work, or closely related field and
• Four (4) years of consultative or supervisory experience in health services, social services, Medicaid, behavioral health, or other health care programs.

Option 3:

• Associate degree with major study in public health, behavioral health, public administration, business administration, social work, or closely related field and
• Six (6) years of consultative or supervisory experience in health services, social services, Medicaid, behavioral health, or other health care programs.

Option 4:

• Eight (8) years of consultative or supervisory experience in health services, social services, Medicaid, behavioral health, or other health care programs.

Option 5:

• One year as a Health Care Program Consultant.

Required competencies:

• The ability to take action to learn and grow.
• The ability to take action to meet the needs of others.
• Excellent oral and written communication skills required.
• Expert in computer software: Windows Excel, Access, PowerPoint.
• Expertise in communications.
• The ability to take action to learn and grow.
• The ability to take action to meet the needs of others.

Preferred qualifications:

Experience:

• Four (4) years of 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.
• Two (2) years of experience in program development, implementation, and evaluation of Medicare.
• Two (2) years of experience in providing behavioral health services at a patient level, including working with culturally diverse populations.
• Knowledge of the structure and function of the various sub-divisions of the Health Care Authority and the Department of Social and Health Services, including experience in cross system collaboration, team building and aligning internal and external resources in support of program development to ensure the delivery of quality health care services to high-risk clients.

Competencies:

• Ability to analyze data related to contract performance and other issues relating to managed care contracts.
• State and federal managed care and related laws (e.g., HIPAA) laws, policies, regulations, and procedures on Medicaid and healthcare both within and outside HCA.
• Familiarity with Care Coordination contract terms and processes.
• Communication skills, including written and oral presentations for a wide variety of audiences, community members, provider groups, clients, and client advocates.

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.

Additional Information

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.
• 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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