Section Manager, Strategic Design and Program Oversight, Medicaid Programs Division (WMS3/MPD)

State of Washington-posted 23 days ago
Full-time • Manager
Hybrid • Olympia, WA
5,001-10,000 employees
Administration of Economic Programs
Resume
Match Score
Upload and Match ResumeTrack Jobs with Teal

This manager oversees a diverse section of professionals who work across HCA, between partner agencies, and with clients, health care providers, and community partners to implement and manage high-quality, evidence-based health care programs, and purchase services that enhance access to care for Medicaid clients and clients of the crisis system. The successful candidate will be a strong relationship manager and strategic thinker who is prepared to take these innovative programs to the next level with a goal of improving patient care. If you are experienced with Medicaid and behavioral health and excited to build and develop groundbreaking programs serving Washingtonians, this may be the opportunity for you! 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 Medicaid Programs Division (MPD) is responsible for the implementation and oversight of Washington Medicaid managed care programs serving approximately 1.9 million Washington residents in all 39 counties. Additionally, the division and this section manager provide contractual oversight to 8 Behavioral Health Administrative Service Organizations (BH-ASOs), manages programs that support the entire Medicaid population, and provides oversight into the state's Dually Eligible Special Needs Program (DSNP). MPD works across HCA and in partnership with the health care community at the local, state, and federal levels, to develop, and manage high-quality, evidence based, health care programs and purchases that meet the needs of Apple Health (Medicaid) clients, and ensures clients are able to access appropriate and quality health care. The mission of MPD and HCA is to provide high quality administrative services to assist in the purchase and delivery of whole person, equitable health care for the medical assistance program services to approximately 1.9 million Washington citizens. About the position: This position manages 23 staff in the Strategic Design and Program Oversight (SDPO) Section divided into two units: BH-ASO Contracts and Community-Based Strategic Design unit. In addition, this position manages two independent professional level contributors. The SDPO Section is responsible for planning, development, and implementation activities related to the Apple Health Integrated Managed Care system design. Additionally, SDPO has responsibility for daily oversight of eight BH-ASO contracts to serve all Washingtonians across the state in need of crisis services, implementing behavioral health state plan amendments, managing Community Behavioral Health Supports (CBHS), Health Homes (HH) and DSNP, standing up supporting programs through waivers, and other efforts. 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.

  • Directly supervises four professional and one administrative staff, including two unit supervisors: one who oversees 11 Behavioral Health contract managers and another who oversees seven staff who manage DSNP integration efforts, HH, and the CBHS Program, respectively.
  • Responsible for the development and submission of behavioral health State Plan Amendments and Waivers in furtherance of our agency mission towards behavioral health integration and whole person care.
  • Leads the process of developing and implementing behavioral health related Federal Waivers.
  • Manages coordination between various programs to ensure high quality and continuity of care between various program options such as managed care, DSNP/Medicare, and fee-for-service.
  • Fosters positive work relationships and coordination with areas of the Apple Health Administration and divisions across HCA.
  • Provides strategic direction and planning to the programs and initiatives assigned to the SDPO division.
  • Oversees staff performing contract management, development, and implementation; development and dissemination of client informational materials; coordination with other areas of HCA, including rates and finance; and coordination and communication with external stakeholders.
  • Provides oversight and direction to the state-wide HH and DSNP integration and care coordination efforts.
  • Provides oversight and direction to the CBHS program.
  • Leads management of new programs, including participation in work groups, developing contracts, and obtaining federal approval for State Plan Amendments and Waivers.
  • Qualifying candidates will satisfy one of the following criteria options: Option 1:  Bachelor's degree in business administration, public administration, public health, or related field,
  • 10 years of experience implementing and operating Medicaid programs (including, but not limited to, experience such as clinic administration, billing and financing, and/or working with insurers and/or managed care plans), and
  • 5 years of experience developing, overseeing or writing contracts.  Note: Required experience types may be gained concurrently. Option 2: Associate degree in business administration, public administration, public health, or related field,
  • 12 years of experience implementing and operating Medicaid programs (including, but not limited to, experience such as clinic administration, billing and financing, and/or working with insurers and/or managed care plans), and
  • 5 years of experience developing, overseeing or writing contracts.  Note: Required experience types may be gained concurrently. Option 3:  14 years of experience implementing and operating Medicaid programs (including, but not limited to, experience such as clinic administration, billing and financing, and/or working with insurers and/or managed care plans), and
  • 5 years of experience developing, overseeing or writing contracts.  Note: Required experience types may be gained concurrently.
  • Facilitate timely communications and interchange between diverse groups of internal and external departments, agencies, and the public.
  • Work effectively with agency staff, providers, and other affected parties to develop managed care programs.
  • Analyze and resolve complex problems related to managed care programs.
  • Collaborate across health care purchasing systems, build teams and work cooperatively with internal and external resources to support program development.
  • Analyze data related to contract performance and other issues related to the managed care contracts.
  • Experience as a clinician, supervisor, or manager in a community or public behavioral health agency or insurer.
  • Experience writing and amending complex contracts and other complex documents.
  • Experience in managed care operations.
  • Experience in complex projects or initiative management within state government.
  • Experience with Medicaid rules and regulations.
  • Direct knowledge of Washington State's community behavioral health system, including outpatient and inpatient care, systems and coordination of treatment (e.g. MCOs, Behavioral Health Agencies, Department of Corrections, DCRs and involuntary treatment, Aging and Long-Term Services Administration, and Developmental Disabilities Administration), understanding of crisis and commitment services, community psychiatric hospitalization, and state hospitals.
  • 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!
Track Jobs with Teal

Job Search Resources

•
Resume Builder
•
Resume Examples
•
Cover Letter Examples

Tools

Career Hubs

Guides

Company

© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service