State Programs Contract Specialist

CHPW•Seattle, WA

5d•Hybrid

About The Position

Provides project coordination, and administrative support, contributing to the efficient and effective achievement of CHPW’s Compliance department. This role reports to the Manager of State Programs. Responsible for State Programs contract management activities across the organization, specific to Washington state Medicaid Programs (i.e., Apple Health Integrated Managed Care (AHIMC), Apple Health Expansion (AHE), Health Homes, State Medicare Advantage Contract (SMAC). To be successful in this role, you: Have a bachelor’s degree in a related field or an equivalent combination of education and highly relevant experience. Have two or more (2+) years’ experience working with contracting agencies, regulators, and marketplace competitors to accomplish CHPW and agency goals. Have two (2+) or more years’ experience facilitating, coordinating, and tracking lifecycles with multi-disciplinary stakeholders. Demonstrated work experience managing multiple goals, tasks, projects to meet deadlines working collaboratively across operational areas. Ability to comprehend and interpret various agency requests to determine next steps with internal stakeholders. Have experience collaborating with internal and external stakeholders.

Requirements

Have a bachelor’s degree in a related field or an equivalent combination of education and highly relevant experience.
Have two or more (2+) years’ experience working with contracting agencies, regulators, and marketplace competitors to accomplish CHPW and agency goals.
Have two (2+) or more years’ experience facilitating, coordinating, and tracking lifecycles with multi-disciplinary stakeholders.
Demonstrated work experience managing multiple goals, tasks, projects to meet deadlines working collaboratively across operational areas.
Ability to comprehend and interpret various agency requests to determine next steps with internal stakeholders.
Have experience collaborating with internal and external stakeholders.
Knowledge and understanding of managed care environment, preferably with state managed Medicaid program(s) a plus.
Excellent analytical and critical thinking skills.
Excellent communication skills with internal and external stakeholders.
Ability to communicate clearly and effectively in both verbal and written form.
Ability to effectively partner across teams to analyze complex problems and implement solutions.
Ability to comprehend and interpret regulatory/contract language and communicate regulatory expectations to stakeholders.
Ability to be organized, methodical and detail oriented, and can plan, organize, and prioritize the work.
Proficient skills with Microsoft Office products such as Word, Excel, Outlook, and Adobe Acrobat.
Complete and successfully pass a criminal background check.
Criminal History: includes review of criminal convictions and probation.
Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.
Vaccination requirement (CHPW offers a process for medical or religious exemptions)
Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.

Nice To Haves

Knowledge and understanding of managed care environment, preferably with state managed Medicaid program(s) a plus.

Responsibilities

Responsible for the implementation and improvement of interdepartmental processes to support CHPW’s Medicaid performance.
Participate in regulatory meetings representing CHPW Compliance and other business owner issues and responses when needed. e., monthly Washington state Health Care Authority (HCA) Managed Care Organization (MCO) Collaborative call, HCA’s Integrated Managed Care (IMC) Managed Care Operations meeting, HCA’s Dual Eligible Special Needs Plan (DSNP) Contractor meeting, HCA Technical Assistance call and HCA delivered training sessions.
Capture and disseminate notes from Managed Care Operations meetings to CHPW business units and may present issues status and notes at PMWG.
Review and summarize Medicaid contract changes (renewals and amendments) for stakeholder review, tracking receipt of stakeholder input, and maintaining library of contract documents on SharePoint.
Tracks and responds to stakeholder questions related to contract language and contractual requirements.
Maintain and track contract deliverables, status and associated deadlines.
Provides support to business areas completing deliverables and escalates potential noncompliance risks.
Facilitates the submission of deliverables on behalf of business owners as needed.
Responsible for administering the MC Track system, including user access, new user training, and troubleshooting all issues.
Functions as the primary point of contact for regulatory inquiries, ensuring timely and appropriate resolution and response.
Disseminate updates from regulatory agencies (e.g., HCA) and maintain tracking log.
Serve as initial contact for internal stakeholder questions on Medicaid requirements and deliverables.
Facilitate questions to regulators when appropriate.
Responsible for the planning, communication, and facilitation of annual Medicaid Audit (TEAMonitor) activities.
Collect and maintain audit related documentation and submissions via SharePoint.
Reviews audit submissions for completion and coordinates with internal business groups to correct deficiencies.
Maintain State Programs SharePoint site with up-to-date and historical documentation and resources for internal workforce member access.
Develop and maintain Compliance (State Program) Desk Procedures, Policies and Procedures, Compliance Team Operations Manual, when needed.
Oversight and monitoring of State Program project management work in-process and operational business owner activities. This includes outreach and management of deliverables to ensure deadlines are met.
Other duties as assigned.