1 School Based Health Care Services Program Specialist (MAPS3/MPD) Job in Olympia, WA

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School Based Health Care Services Program Specialist (MAPS3/MPD)

State of Washington Health Care Authority

Olympia, WA | Full Time

$89k-112k (estimate)

1 Month Ago

School Based Health Care Services Program Specialist (MAPS3/MPD)

$89k-112k (estimate)

Full Time 1 Month Ago

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State of Washington Health Care Authority is Hiring a Remote School Based Health Care Services Program Specialist (MAPS3/MPD)

Description

School Based Health Care Services Program Specialist (MAPS3/MPD)

71028902

Are you ready to make a difference in the lives of thousands of children across the state? Join us as the School Based Health Care Services (SBHS) program specialist and become the go-to expert providing invaluable consultation and technical expertise on the SBHS program! From liaising with executive management to overseeing Medicaid reimbursements, your role will be pivotal in shaping policies, monitoring compliance, and driving impactful change statewide. If you are passionate about program management and eager to make a meaningful impact, apply now and be a part of our dynamic team!

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 Mission of Medicaid Programs Division (MPD) is to work across the agency and in partnership with the health care community and community stakeholders to develop and manage high-quality, evidence-based health care programs and purchase services that enhance Medicaid enrollees’ ability to access appropriate, quality health care. Staff in Managed Care Programs oversee a Statewide managed care program that provides services to Medicaid enrollees, including vulnerable SSI Blind and Disabled enrollees. The managed care program has approximately 1.5 million enrollees and 300,000 clients in Apple Health without a Managed Care Plan. Total expenditures per biennium for the Apple Health Managed Care Program are approximately $8 billion.

About the position:

The School Based Health Care Services (SBHS) program specialist provides consultative professional and technical expertise regarding the SBHS program to HCA’s executive management, federal, state, and local government agencies, the private sector, and the general public. The SBHS program has a budget of approximately $13 million and administers Medicaid reimbursements to school districts and educational services districts that provide medically necessary services to approximately 22,000 Medicaid eligible children in special education each year.

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. Frequency of onsite work will vary based on business and operational needs. HCA may choose, but is not required, to support out-of-state telework on a case-by-case basis.

Duties

Some of what you will do:

Develop, lead, and administer the statewide program operations of the SBHS program for children in special education in compliance with federal and state Medicaid rules.
Provide expert advice and recommendations to HCA executive management, section, and unit supervisors regarding compliance with program quality improvements, based on interpretation of federal rules related to Title XIX, IDEA Part B guidelines, and federal regulation updates.
Exercise delegated authority to represent HCA in matters involving the SBHS program with the Centers for Medicare & Medicaid Services (CMS), Legislature, Office of Superintendent of Public Instruction (OSPI), State Auditor’s Office (SAO), Attorney General’s Office (ATG), other state and local agencies, school districts, educational service districts, National Alliance for Medicaid in Education (NAME), and other external stakeholders regarding the SBHS program.
Develop and deliver statewide training and provide technical assistance to all SBHS participating school districts and educational service districts.
Develop, write, stakeholder, and implement needed State Plan Amendments, Washington Administrative Code, Revised Code of Washington, and Medicaid Provider Guides to ensure program adherence to all applicable le federal and state rules and regulations regarding Medicaid reimbursable services, billing requirements, and reimbursement processes.
Initiate and coordinate contract planning, negotiation, writing special terms and conditions to the contract, and adding documentation to the contract records database. Implement executed SBHS contracts and oversee ongoing program compliance for all SBHS contracts.
Provide consultation and technical assistance to HCA executive management, section manager, direct unit supervisors, section team members, staff at OSPI, and stakeholders regarding existing SBHS contracts and program changes.
Provide technical assistance to the school districts and educational service districts on the SBHS contract participation, documentation of performance and proper claiming and reimbursement processes through ProviderOne.
Work with HCA contract staff to execute SBHS contracts statewide. Coordinate the maintenance and updates to HCA’s contract databases to include all monitoring, technical assistance, changes in schools and educational service districts management notification, and any scheduled on-site visits.
Monitor SBHS contract requirements statewide to ensure compliance with applicable federal and state rules and regulations regarding reimbursable direct health care related services, claiming and reimbursement process.
Consult and coordinate with HCA fiscal, rates, and ProviderOne staff on allocation and billing mechanisms using the Correct Procedures Terminology (CPT) coding, National Correct Coding Initiative (NCCI) to comply with federal, state, and HCA rules for claims payment.
Develop, deliver, and utilize effective external communications plan with schools and educational service districts statewide related to program participation, policy updates, federal and state resources, training opportunities and other materials provided by HCA. This is accomplished using the SBHS website and written communication methods.
Plan, develop, implement, and report on monitoring program compliance with all school districts and educational service districts participating in the SBHS program.

Qualifications

Required qualifications:

A master’s degree with major study in public health, public administration, education, social work, social services, or a closely allied field.

AND

Three (3) years consultative experience in health services, social services, education administration, Medicaid programs and/ or direct contract management activities including experience in stakeholder management, contract negotiations, contract writing, contract monitoring, and development of corrective action plans and follow up with the contractor.

Note: Two (2) additional years of qualifying experience will substitute for the required master’s degree provided a bachelor’s degree has been achieved.

One (1) year as a Medical Assistant Program Specialist 2

Additional qualifying experience may substitute year for year, for required education.

Preferred qualifications:

Leadership skills including the ability to work across boundaries, build and sustain effective teams, evaluate, and implement program/process improvements.
Able to manage multiple activities, establish priorities, work independently and advance assigned projects from inception to completion with limited supervision.
An understanding of the Individuals with Disabilities Education Act (IDEA) and the unique relationship between IDEA and Section 1903(c) of the Social Security Act.
Knowledge of OSPI, Educational Service District and School District organizational structures.
Knowledge of medical aspects of disability and resultant handicapping conditions.
Possess familiarity with medical terminology.
Knowledge of the ProviderOne (MMIS) system.

How to apply:

Only candidates who reflect the minimum qualifications on their NEOGOV profile will be considered. Failure to follow the application instructions below may lead to disqualification. To apply for this position, you will need to complete your profile which includes three professional references and attach:

A cover letter that specifically addresses how you meet the qualifications for this position.
Current resume

To take advantage of veteran preference, please do the following:

Attach a copy of your DD214 (Member 4 long-form copy), NGB 22, or USDVA signed verification of service letter.
Please black out any PII (personally identifiable information) data such as social security numbers. Include your name as it appears on your application in careers.wa.gov.

Supplemental Information

About HCA:
Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.
What we have to offer:

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.
Tuition reimbursement
And free parking!

Notes:

Prior to a new hire, a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment.

HCA is an equal opportunity employer. We value the importance of creating an environment in which all employees can feel respected, included, and empowered to bring unique ideas to the agency. HCA has five employee resource groups (ERGs). ERGs are voluntary, employee-led groups whose aim is to foster a diverse, inclusive workplace aligned with HCA’s mission.Our diversity and inclusion efforts include embracing different cultures, backgrounds and viewpoints while fostering growth and advancement in the workplace. Studies have shown women, racial and ethnic minorities, persons of disability, persons over 40 years of age, disabled and Vietnam era veterans, as well as people of all sexual orientations and gender identities are less likely to apply for jobs unless they feel they meet every qualification as described in a job description. If you have any questions about the required qualifications or how your experience relates to them, please contact us at HCAjobs@hca.wa.gov. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact julie.laney@hca.wa.gov.

The Washington State Health Care Authority (HCA) is an E-Verify employer. All applicants with a legal right to work in the United States are encouraged to apply.

E-Verify® is a registered trademark of the U.S. Department of Homeland Security.

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