BHASO TEAMonitor Coordinator (HCPS/MPD) - Internal

State of Washington•Thurston County – Olympia, WA

6d•Hybrid

About The Position

This position coordinates annual compliance reviews for Behavioral Health Administrative Services Organizations (BH-ASO). This process includes subject matter experts and contractors, requiring a candidate with strong organizational skills to ensure these audits are completed on federally-mandated timelines. The purpose of this position is to provide a coordinated monitoring effort as a member of the team that performs federally required oversight of HCA-contracted Managed Care Organizations (MCOs) and contractual compliance monitoring of the BH-ASOs (collectively referred to as Contractors). This position uses project management and group facilitation to perform compliance reviews of contractually required topical areas (e.g., credentialing, grievances, subcontracts) as well as non-clinical file reviews of individual client and provider services. The position reviews MCO and BH-ASO materials and applies judgment and contractual knowledge to evaluate the completeness of information according to federal regulations and national standards. This position is eligible to telework and is typically not required to report on-site. 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. All agency employees are required to report on-site in Olympia on their first and last days of employment to pick up and return state-issued equipment, regardless of telework status or location.

Requirements

Master’s degree in public health, public administration, business administration, social work, or closely related field and Two (2) years of supervisory or consultative experience in health services, social service, Medicaid, behavioral health, or other healthcare programs.
Bachelor’s degree in public health, public administration, business administration, social work, or closely related field and Four (4) years of supervisory or consultative experience in health services, social service, Medicaid, behavioral health, or other healthcare programs.
Associate degree in public health, public administration, business administration, social work, or closely related field and Six (6) years of supervisory or consultative experience in health services, social service, Medicaid, behavioral health, or other healthcare programs.
Eight (8) years of supervisory or consultative experience in health services, social service, Medicaid, behavioral health, or other healthcare programs.
One year as a Health Care Program Consultant.
The ability to take action to learn and grow.
The ability to take action to meet the needs of others.

Nice To Haves

Two (2) years of experience as a Health Care Program Specialist or comparable experience working in Medicaid or commercial insurance program.
Experience in Medicaid managed care operations.
Experience in contract management and accountability.
Ability to: Work effectively with other HCA staff, providers, and other affected parties to develop and evaluate programs and analyze and resolve complex problems related to managed care programs.
Collaborate across systems, build teams, and work cooperatively with internal and external resources for successful program management and development.
Analyze data related to contract performance and other issues relating to the managed care contracts.
Public relations and customer service skills, including conflict resolution and negotiating techniques.

Responsibilities

Coordinate annual formal monitoring and oversight of regional BH-ASOs according to contractual requirements, Department of Enterprise Services (DES) contract management standards, and federal block grant requirements.
Support development and revision of documentation tools, guidelines, file review checklists, correspondence, and report formats.
Support development of work tools to facilitate consistency of the monitoring review process.
Coordinate annual review monitoring of each contracted BH-ASO.
Coordinate annual virtual visits to each contracted BH-ASO.
Assign and plan the work of Medicaid Compliance Review staff with other subject matter experts within the agency.
Perform analysis and interpretation of contract monitoring results.
Recommend needed improvement in programs, policies, and contract.
Serve as support to TEAMonitor Coordinator in MCO TEAMonitor activities, including ensuring contractor compliance with federal and state regulations and Centers for Medicare and Medicaid Services (CMS) requirements.
Serve as program specialist for annual formal monitoring and oversight of federally required monitoring of MCOs.
Attend HCA/Contractor monthly meetings to inform monitoring activity changes and communicate key information.
Recommend and support implementation of changes in HCA monitoring process to promote administrative simplification and transparency and to increase efficiency for agency and contractor staff.