Health Care Program Manager (HCPMFS)

Thurston County, WA - USA

Yearly Salary: $ 78912 - 106104

Posted on: 7 hours ago

Vacancies: 1 Vacancy

Job Summary

Description

Health Care Program Manager (HCPM/FS)

This Health Care Program Manager (HCPM) is ideal for a healthcare policy finance or compliance professional seeking high-level influence as it acts as the state-wide subject matter expert for Medicaid supplemental payments (ODP IDP ASSP PSSP PAP). It offers significant career impact through shaping policy interpreting federal CMS regulations collaborating with actuaries and managing critical funding for providers.

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 Financial Services Division (FSD) in collaboration with other HCA divisions and a variety of external stakeholders and legislative partners provides strategic financial expertise for Apple Health Community Behavioral Health (CBH) PEBB and SEBB addition FSD oversees the budget and compliance functions necessary to manage and monitor the single largest Washington State individual operating budget. Functions include budget management accounting forecasting professional and hospital rate setting financial analysis and payment/collection operations. This division maintains a close working relationship with agency program policy and clinical divisions to ensure financially sound implementation and monitoring of program strategies. It is also accountable to the Governor and legislature in ensuring HCA operates within its budget.

About the position:
This Health Care Program Manager (HCPM) serves as the program manager responsible for managing the Outpatient Directed Payment (ODP) Inpatient Directed Payment (IDP) Airlift Services Supplemental Payment (ASSP) Professional Services Supplemental Payment (PSSP) and Provider Access Payment (PAP) and other supplemental payment programs as assigned. As the state-wide subject matter expert for all technical and policy matters providing supplemental payments for hospital and professional services. This position is responsible for stakeholder communications regarding the ODP IDP ASSP PSSP and PAP programs as well as other supplemental payment programs as assigned.

This position is eligible to telework but is frequently required to report on-site to meet business need. 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.

Duties

Some of what you will do:

Program management for the following supplemental payment programs: Academic Medical Center ODP and IDP ASSP PSSP PAP and other supplemental payment programs as assigned.
Manage all aspects of assigned supplemental payment programs including inpatient and outpatient academic medical center providers professional services at public hospitals and publicly owned airlift services for both Fee-For-Service (FFS) and Managed Care enrolled clients.
Plan design develop and maintain documentation and fiscal modeling of the ODP IDP ASSP PSSP PAP and other supplemental payment programs as assigned to include program communications provider inquiries WAC policy documentation and program manuals.
Extensively review design develop and maintain systems for tracking analyzing and reporting assigned supplemental payment programs utilizing Excel at the expert level and SQL at the intermediate level.
Prepare budget allotment requests and justifications for ODP IDP ASSP PSSP and PAP programs and other supplemental payment programs as assigned; verify adequacy and accuracy of supporting data.
Supports the development of the bi-annual forecast through subject matter expertise and fiscal analysis.
Develop and generate provider communications and invoices for support of ODP IDP ASSP PSSP PAP programs and other supplemental payment programs as assigned.
Manage and facilitate the state directed payments with CMS to obtain authority for ODP IDP ASSP PSSP and PAP programs and other supplemental payment programs as assigned.

Qualifications

Required qualifications:

Qualifying candidates will meet one of the following criteria options:

Option 1:

Masters degree with major study in public health behavioral health public administration business administration social work or closely related field.
Three (3) years consultative or supervisory experience in health services social services Medicaid behavioral health or other health care programs.

Option 2:

Bachelors degree with a major study in public health behavioral health public administration business administration social work or closely related field.
Five (5) years consultative or supervisory experience in health services social services Medicaid behavioral health or other health care programs.

Option 3:

Nine (9) years consultative or supervisory experience in health services social services Medicaid behavioral health or other health care programs.

Option 4:

One (1) year as a Health Care Program Specialist.

Required competencies:

The ability to take action to learn and grow.
The ability to take action to meet the needs of others.
Must be able to communicate in a positive manner with diverse audiences and facilitate large and small teams.
The ability to anticipate assess and respond effectively to the needs of diverse customers; making excellent Customer service a high priority in order to attract support and maintain our customer base.
The employees ability to take responsibility for their own performance by setting clear goals and balancing critical job requirements through the proper use of task management results orientation stress management and problem-solving skills.
Consistent with Procurement Reform Law (RCW 39.26.110) this position requires the completion of the following DES contracts training courses within 90 days of hire: All courses required for School of Contract Managers and Monitors.

Preferred qualifications:

Four (4) years working experience and in-depth working knowledge of hospital payment methodologies related to Medicaid Medicare and commercial payers and federal supplemental payment programs.
Intermediate skills utilizing and interpreting structured query language or other related database query language.
Experience with MMIS (ProviderOne) system.
Ability to perform complex financial analyses using financial data and financial modeling.
Ability to perform statistical analyses.
Ability to analyze and interpret Medicare/Medicaid cost reports.
Advanced project management skills involving stakeholders with varied interests both internal and external to HCA.
Advanced level knowledge of hospital related claims and billing policy ICD-10 diagnosis codes and operating procedures Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS).

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.

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 .

Supplemental Information

About HCA:
Functioning as both the states 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 serveVoices of HCA
A clear agency mission that drives our work and is person-centeredHCAs Mission Vision & Values
A healthy work/life balance including alternative/flexible schedules and mobile work options.
A great total compensation and benefit packageWA 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 HCAs 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. Persons with disabilities needing assistance in the application process or those needing this job announcement in an alternative format may contact Angelic Matthews at

The Washington State Health Care Authority (HCA) is anE-Verify employer. All applicants with a legal right to workin 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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Required Experience:

Manager

DescriptionHealth Care Program Manager (HCPM/FS)This Health Care Program Manager (HCPM) is ideal for a healthcare policy finance or compliance professional seeking high-level influence as it acts as the state-wide subject matter expert for Medicaid supplemental payments (ODP IDP ASSP PSSP PAP). It o...