State Programs Contract Specialist

This is a hybrid position; we are open to any candidates that reside in Washington State. Quarterly travel to our Seattle headquarters may be required.

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Our commitment is to:

• Strive to apply an equity lens to all our work.
• Create an equitable work environment.

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).

• 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 life cycles 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.

• 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 (TEA Monitor) 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…