Functional Program Analyst 3 (HCBM Analyst)

State of Washington•Thurston County – Tumwater, WA

2d•$5,137 - $6,906•Hybrid

About The Position

This position is within the Rates, Forms, and Provider Network (RFPN) Division and focuses on reviewing complex healthcare contracts, evaluating them for compliance with state and federal requirements, and documenting findings. The role requires strong analytical thinking, sound judgment, and effective communication with various stakeholders. The Functional Program Analyst 3 (HCBM Analyst) will review contract filings submitted by health carriers, Health Care Benefit Managers (HCBMs), providers, pharmacies, and Pharmacy Services Administrative Organizations (PSAOs) to ensure accuracy, compliance, and alignment with regulatory expectations. This involves analyzing contract language, identifying issues, and providing clear written findings to support consistent oversight. The role also includes conducting research and offering subject matter guidance to carriers, HCBMs, agents, attorneys, and consumers, including discussing contract provisions, interpreting case law, and resolving questions or concerns. This role is suitable for individuals who enjoy detailed analytical work, clear communication about complex topics, and contributing to fair and transparent healthcare practices. Team members are required to be in-office for a portion of their first 90 days, with a reduced in-office requirement thereafter. This recruitment may establish a qualified pool for future vacancies.

Requirements

Six (6) years of professional full-time work experience in areas such as contract management, drafting and/or review of legal documents; regulatory examinations, regulatory compliance, or health care benefit plan design, distribution, or administration.
Intermediate-level skills in Microsoft Outlook, Word, and Excel.

Nice To Haves

Advanced skills and experience in Microsoft Outlook, Excel, Word
Demonstrated experience organizing work, establishing timelines, and meeting deadlines.

Responsibilities

Independently analyze/review and evaluate contracts to ensure compliance with Washington State insurance laws, federal laws, regulations, and applicable case law.
Interpret contract language and assess whether legal and regulatory standards are met.
Apply relevant RCWs, WACs, federal requirements, and case law to support consistent, legally sound contract reviews and regulatory decisions.
Identify compliance issues, deficiencies, or provisions that do not meet regulatory requirements and develop clear, well-reasoned recommendations or objections outlining how contracts can be brought into compliance.
Collaborate with the Functional Program Analyst 4 Supervisor, Program Manager, and OIC colleagues regarding contract review issues that may impact the broader insurance marketplace and support consistent and uniform contract review standards.
Support the OIC’s consumer protection mission by helping ensure that regulated entities issue contracts that are fair, transparent, and compliant before entering the marketplace.