Medical Assistance Specialist 4 (MAS4AHSO) – Internal

Medical Assistance Specialist 4 (MAS4/AHSO) Internal

This opportunity is internal and available to current HCA employees only.

This recruitment will be used to fill multiple positions.

The Medical Assistance Specialist 4 serves as a lead worker supporting Washington State residents in accessing Medicaid CHIP and other state-funded programs bringing expertise in eligibility policy to the Medical Eligibility Determination Services (MEDS) team. This role combines conducting hands-on eligibility determinations with training auditing and workflow oversight responsibilities.

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 organizations mission is to provide high quality health care through innovative health policies and purchasing strategies. The Apple Health Services and Operations (AHSO) Division works across the Health Care Authority (HCA) and in partnership with the health care community at local state and federal levels in order to develop and manage high quality and evidence-based health care programs and purchase services that enhance Washington States citizens ability to access appropriate quality health care.

About the position:

The Medical Assistance Specialist 4 supports the HCA mission to provide access to medical care for all eligible Washington citizens. The position serves as a lead worker in a team of Medical Assistance Specialists and determines initial eligibility and/or ongoing individual and family medical eligibility for Medicaid Title XIX Childrens Health Insurance Program (CHIP) Title XXI programs and other Medicaid and state funded medical assistance programs available in Washington State.

Some of what you will do:

• Provide eligibility support and clarification to MAS-level staff determining initial eligibility and/or ongoing medical eligibility.
• Eligibility expert interprets policy and regulations analyzes workflow and automated systems problems devises and implements new and revised procedures and monitors ongoing systems operations in the broader aspects of MEDS related system activities.
• Provide eligibility training for new staff to determine initial and/or ongoing eligibility for Health Care Authority medical programs.
• Provide system training interviewing and workload management for new staff.
• Apply complex federal and state eligibility regulations published in WAC and RCW to specific household circumstances.
• Develop eligibility and system training for new and seasoned staff based on program changes and changes to eligibility.
• Develop and provide training on identified performance gaps.
• Use and manage multiple inter-dependent electronic systems including but not limited to the Automated Client Eligibility System (ACES) Provider One Audit Plus Microsoft Office SOLQ Document Management System (DMS) SEMS TALX DOH and the Employment Security Department (ESD).
• Conduct internal program audits of new and experienced staff identifying error trends and performance issues.
• Work with individual Take Charge providers to answer inquiries and resolve issues related to eligibility for the Take Charge Family Planning program.
• Assist supervisors and lower-level specialists in determining final disposition of complex eligibility cases.
• Monitor the ongoing activity of providers and clients that have been identified as deviating from the pre-described norms of practice.
• Monitor team workload and priorities.
• Support management directives.
• Maintain confidentiality in all interactions as appropriate.

Required qualifications:

Qualified candidates will satisfyone of the following options:

Option 1:

• Bachelors degree and
• Two (2) years of experience as defined below

Option 2:

• Associate degree and
• Four (4) years of experience as defined below

Option 3:

• Six (6) years of experience as defined below

Option 4:

• One (1) year of experience as a Medical Assistance Specialist 3

Qualifying experience includes the following:

• Providing direct client services or counseling of customers in the areas of health insurance disability or other related health benefits;
• Public assistance eligibility determination;
• Health insurance premiums/claims processing adjusting and investigation;
• Other medical premiums/claims related experience.

Required competencies:

• The ability to take action to learn and grow.
• The ability to take action to meet the needs of others.

Preferred qualifications:

• ACES HealthPlanFinder MVP Provider One and/or Barcode/DMS experience.

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 .

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 serve Voices of HCA
• A clear agency mission that drives our work and is person-centered HCAs 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 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 Angel Matthews at or .

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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