Health Care Program Manager; HCPM​/FS

Overview

Health Care Program Manager (HCPM/FS)

This Health Care Program Manager (HCPM) is ideal for a healthcare policy, finance, or compliance professional seeking high-level influence, as it acts as the state-wide subject matter expert for Medicaid supplemental payments (ODP, IDP, ASSP, PSSP, PAP). It offers significant career impact through shaping policy, interpreting federal CMS regulations, collaborating with actuaries, and managing critical funding for providers.

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.

The Financial Services Division (FSD), in collaboration with other HCA divisions and external stakeholders and legislative partners, provides strategic financial expertise for Apple Health, CBH, PEBB and SEBB programs. FSD oversees the budget and compliance functions necessary to manage and monitor Washington State s single largest operating budget. Functions include budget management, accounting, forecasting, rate setting, financial analysis, and payment/collection operations.

The division works with agency program, policy, and clinical divisions to ensure financially sound implementation and monitoring of program strategies and is accountable to the Governor and legislature.

• Manage the Outpatient Directed Payment (ODP), Inpatient Directed Payment (IDP), Airlift Services Supplemental Payment (ASSP), Professional Services Supplemental Payment (PSSP), Provider Access Payment (PAP), and other supplemental payment programs as assigned.
• Oversee all aspects of assigned supplemental payment programs for inpatient/outpatient providers, professional services at public hospitals, and airlift services for both Fee-For-Service (FFS) and Managed Care enrolled clients.
• Plan, design, develop, and maintain documentation and fiscal modeling for the programs, including communications, provider inquiries, policy documentation, and program manuals.
• Develop systems for tracking, analyzing, and reporting program data using Excel (expert) and SQL (intermediate).
• Prepare budget allotment requests and justifications; verify data adequacy and accuracy.
• Support bi-annual forecasting with subject matter expertise and fiscal analysis.
• Develop and generate provider communications and invoices for the programs.
• Manage and facilitate state-directed payments with CMS to obtain authority for the programs as assigned.

Qualifying candidates will meet one of the following criteria options:

Option 1:

• Master’s degree with major study in public health, behavioral health, public administration, business administration, social work, or closely related field.
• Three (3) years consultative or supervisory experience in health services, social services, Medicaid, behavioral health, or other health care programs.

Option 2:

• Bachelor’s degree with major study in public health, behavioral health, public administration, business administration, social work, or closely related field.
• Five (5) years consultative or supervisory experience in health services, social services, Medicaid, behavioral health, or other health care programs.

Option 3:

• Nine (9) years consultative or supervisory experience in health services, social services, Medicaid, behavioral health, or other health care programs.

Option 4:

• One (1) year as a Health Care Program Specialist.

• The ability to take action to learn and grow.
• The ability to take action to meet the needs of others.
• Must be able to communicate in a positive manner with diverse audiences and facilitate large and small teams.
• The ability to anticipate, assess, and respond effectively to the needs of diverse customers; making excellent customer service a high priority.
• The employee’s ability to take responsibility for their own performance by setting clear goals and balancing critical job requirements.
• Consistent with Procurement Reform Law (RCW 39.26.110), completion of DES contracts training courses within 90 days of hire: all courses required for School of Contract Managers and Monitors.

• Four (4) years of working…