Functional Program Analyst – HCBM Analyst

Description

This recruitment will remain open until February 16, 2026. The agency reserves the right to make a hiring decision at any time after the initial screening date on January 23, 2026. It is in the applicant’s best interest to submit materials as soon as possible.

Make a Difference:
Protect Consumers & Join Our Dynamic Team! The Office of the Insurance Commissioner (OIC) seeks a qualified individual for the Functional Program Analyst 3 – HCBM Analyst position. This role is within the Rates, Forms, and Provider Networks Division and is based out of our Tumwater Office.

At the Washington State Office of the Insurance Commissioner (OIC), our work matters. Every day, we protect consumers, the public interest, and Washington’s economy by ensuring the insurance marketplace operates fairly, transparently, and lawfully. Our teams safeguard access to health care, hold systems accountable, and help ensure that contracts governing critical health services put people first.

The Functional Program Analyst 3 plays a vital role in this mission. As part of the Provider Network Oversight Program within the Rates, Forms, and Provider Networks Division, this position serves as a key reviewer and analyst of Health Care Benefit Manager (HCBM) contracts. Through independent, thoughtful analysis of complex contract language, this role helps ensure that health carriers and HCBMs comply with state and federal laws designed to protect consumers and preserve the integrity of the insurance system.

This is meaningful, high-impact work. The decisions and recommendations made in this role directly influence how health care services are authorized, delivered, and paid for across Washington State. By identifying compliance issues, collaborating with internal experts, and working constructively with regulated entities, this position helps improve contract practices before they reach the marketplace—protecting consumers before problems arise.

If you are energized by detailed analysis, motivated by public service, and want your expertise to make a real difference in people’s access to health care, this role offers the opportunity to do work that truly matters.

This recruitment may be used to establish a qualified pool of candidates for Functional Program Analyst 3 vacancies in the next sixty days. This is a Washington General Service position. The monthly salary range for this position is $5,137 - $6,906.

• Comprehensive benefits package:
  Health, dental, vision, retirement, paid leave (vacation, sick, etc.) and much more.
• Supportive work environment:
  We value diversity, professional growth, and collaborative atmosphere.
• Wellness programs:
  Invest in your well-being with on-site resources and initiatives.
• Work-life balance:
  Flexible schedules with telework opportunities.
• Public service fulfillment:
  Contribute to a cause that matters and feel the satisfaction of serving the public good.
• Training & Development:
  Tuition reimbursement, Public Service Loan Forgiveness, and other programs.
• Free parking (Tumwater) & Public transportation pass (Thurston County).
• And more! Explore our website for additional benefits.

• Independently analyze and evaluate Health Care Benefit Manager (HCBM), health carrier, provider, pharmacy, and related contract forms to ensure compliance with Washington State insurance laws, regulations, applicable case law, and federal requirements.
• Review complex contractual documents, including Statements of Work, Business Associate Agreements, base contracts, templates, and amendments, to assess whether legal and regulatory standards are met.
• Interpret and assess contract provisions governing prior authorization, medical necessity determinations, utilization review, claims processing, provider credentialing, payment methodologies, dispute resolution, appeals, provider network management, and disease or care management activities.
• Identify compliance issues, deficiencies, or areas of concern and develop clear, well-reasoned recommendations for corrective contract language or action.
• Apply and interpret relevant RCWs, WACs, and case law to support consistent, legally sound contract reviews and…