Professional Worker III (Med-Quest) - Oahu (Ohhi)

State of Hawai'i • Island of Oahu, HI

3d

About The Position

The Professional Worker III reflects the first independent worker level in a series of professional work. Work assignments routinely encompass problems of average difficulty and complexity, requiring the application of technical knowledge, skills and sound judgment in applying the fundamental principles, techniques, standards, policies, procedures, rules and regulations pertinent to the occupational specialty and program area. Problems encountered are usually those which can be resolved by direct application of specific standards, regulations or other similar guides. Additional assignments are selected to develop the employee for eventual progression to the fully independent worker level.

The Contracts Specialist (MED-QUEST) position is a fully independent worker level, coordinates and participates in the administration of contracts entered into by the State's QUEST medical assistance program, including establishing contracts with assigned health plans and individual providers to provide comprehensive medical, dental, and behavioral health services to eligible individuals and families. Responsibilities also include working closely with divisional staff and representatives of the health plans in monitoring and evaluating the performance of contracted parties to assure compliance with the terms and conditions of the contracts; serving as a liaison for the State's medical assistance program with contracted parties, recipients, and other programs, agencies and/or individuals; coordinating and participating in the evaluation of contract proposals and recommending additional terms and conditions, if necessary; and participating in rate negotiations. This position also participates in assessing administrative requirements and contributes in other areas based on the ongoing monitoring and evaluation of assigned health plans; is involved in the development of new medical assistance programs; and performs other related duties as assigned.

Requirements

• Legal Authorization to Work: The State of Hawaii requires all persons seeking employment with the government of the State shall be citizens, nationals, or permanent resident aliens of the United States, or eligible under federal law for unrestricted employment in the United States.
• Knowledge of: Research methods and techniques; report writing, problem solving methods and techniques; principles, techniques, standards, policies, procedures, rules and regulations pertinent to the occupational specialty and program area (e.g., knowledge of health care delivery systems; current principles and practices in health care financing; principles and practices of contract administration; various provisions found in service provider contracts; evaluative techniques; problem solving methods and techniques; and report writing).
• Ability to: Obtain pertinent factual data; analyze and make sound recommendations as to the action to be taken; successfully complete assignments selected to develop the employee for higher level work; communicate effectively with others orally and in writing; and establish and maintain effective working relationships with others.
• Education: A bachelor's degree from an accredited four-year college or university.
• Specialized Experience: One and one-half (1-1/2) years of progressively responsible professional work experience in the development and/or administration of contracts which significantly involved one (1) OR a combination of the following: A. Preparing proposals or formal requests for proposals for contractual services which involved the application of professional judgment and analysis in determining contract terms and conditions and/or developing proposals to meet such requirements; OR B. Evaluating, developing, negotiating, or revising the content of proposals and/or contracts; OR C. Monitoring and evaluating the performance of contracted parties to ensure compliance with the terms and conditions stipulated in the contracts.

Nice To Haves

• A law degree from a school of law accredited by a nationally recognized specialized accrediting body (or course work deemed comparable by a nationally recognized specialized accrediting body) may be substituted for one year of Specialized Experience.

Responsibilities

• Coordinates and participates in the administration of contracts entered into by the State's QUEST medical assistance program.
• Establishes contracts with assigned health plans and individual providers to provide comprehensive medical, dental, and behavioral health services to eligible individuals and families.
• Works closely with divisional staff and representatives of the health plans in monitoring and evaluating the performance of contracted parties to assure compliance with the terms and conditions of the contracts.
• Serves as a liaison for the State's medical assistance program with contracted parties, recipients, and other programs, agencies and/or individuals.
• Coordinates and participates in the evaluation of contract proposals and recommending additional terms and conditions, if necessary.
• Participates in rate negotiations.
• Assesses administrative requirements and contributes in other areas based on the ongoing monitoring and evaluation of assigned health plans.
• Involved in the development of new medical assistance programs.
• Performs other related duties as assigned.

Benefits

• The State of Hawai'i complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities.
• PUBLIC SERVICE LOAN FORGIVENESS (PSLF) PROGRAM: The PSLF Program is a federal program that is intended to encourage individuals to work in public service by forgiving the balance of their federal student loans. To qualify, the individual must have made 120 qualifying payments while employed by a qualifying employer.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level