.. screen is required. Please note nicotine levels are included in testing. Medical Billing Specialist Job Duties: Answering patient phone calls related to their Medical Billing. Monitoring insurance reimbursement to ensure insurance is processing according to contracted fee schedule. Monitoring patient .. read more
Adult Reentry - Medical Assistance Program Specialist 3(MAPS3/MPD) - Project B533 This is a project position funded through June 30, 2028. Are you passionate about making a difference in the lives of individuals reentering society? On this team, you'll play a critical role in shaping and coordinating medical assistance programs across various systems, including carceral/justice facilities. Join us in this impactful position where your expertise will guide the comprehensive design, management, and oversight of policies that support the successful reintegration of adults from public institutions. 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 Medicaid Programs Division (MPD) is responsible for the implementation and oversight of Washington Medicaid managed care programs serving nearly 2.1 million Washington residents in all 39 counties. MPD works across the Heath Care Authority (HCA) and in partnership with the health care community and local, state, health care, and federal levels, to develop, and manage high-quality, evidence based, health care programs and purchases that enhance Apple Health (Medicaid) managed care. MPD is responsible for managed care implementation and alignment with fee-for-service. About the position: The Reentry Program Medical Assistance Program Specialist 3 (MAPS3) is a subject matter expert, directly responsible for overseeing medical policies and procedures for the statewide reentry program. As the subject matter expert, this position is responsible for developing and writing policies and procedures; providing Medicaid business requirements for eligibility system changes; representing the agency to external stakeholders and governments, which may include Tribes, the Center for Medicaid and Medicare, Legislature, constituents and the client community; provide community and staff trainings, collaborate in comprehensive program design and development; administer contracts; perform program and contract monitoring; process claims; develop and maintain program guidance manuals and training materials; develop and conduct program training and make presentations; and support health related social needs. 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. Some of what you will do: * Directly responsible for using independent judgment and program subject matter expertise and knowledge to develop, write, and oversee all aspects of the assigned Reentry program including business requirements, policy promulgation, contract administration, contract monitoring, claiming processes and payment; writing and maintaining reentry policy/billing guides; develop and maintain training manuals/materials; provide provider and stakeholder training to ensure the HCA's reentry activities and processes are in compliance with state and federal guidelines and meet CMS standards. * Build and maintain partnerships with community organizations, correctional facilities, and other stakeholders to enhance the effectiveness of the Reentry Program. This includes Blake, MOUD in jails and HEP C, HIV programs and Pharmacy. * Track and report on the progress of program participants, contributing to the overall success and impact of the reentry initiative. * Collaborate with carceral and legal partners to understand the needs of the Medicaid eligible incarcerated community and facilitate reentry/resource groups at statewide correctional facilities (in coordination with community partners when appropriate) to address identified needs. * Conduct reentry needs assessments, develop reentry plans, and coordinate services with community resources, in order to best connect with available services and inform future policies for serving the Medicaid eligible incarcerated community. * Identify gaps and barriers in available community resources and advocate for systemic changes. Network with other jurisdictions to coordinate and share information. * Plan, design, develop, write, schedule, implement, evaluate and improve on-going training relating to reentry program modifications needed to ensure reentry program is in compliance with federal guidelines. Required qualifications: * A master's degree from an accredited college with a major study in public health, public administration, business administration, social work or closely related field AND * Three (3) years supervisory or consultative experience in health services, social service, Medicaid or social security disability programs. OR * Nine (9) year's total experience supervisory or consultative experience in health services, social service, and Medicaid programs. Two additional years of qualifying experience will substitute for the required master's degree provided a bachelor's degree from an accredited college has been achieved. ' OR * One (1) year as a Medical Assistance Program Specialist (MAPS) 2 OR Two years as a Medical Assistance Program Specialist (MAPS) 1 Additional qualifying experience may substitute year for year, for required education. Qualified candidates must also have: * Two (2) years of experience working in quality assurance and process improvement methodologies such as Lean or project management experience. * Data-oriented, self-directed personality with strong analytical and problem-solving skills. * Analyzing policies, laws, rules, or regulations. * Conducting business analysis and developing requirements. * Leading business projects. * Managing business operations. * Business policy development. Preferred qualifications: * Work independently with limited supervision, utilizing available tools and resources to complete work assignments accurately and on time. * Communicate and work effectively with a broad range of stakeholders with input and influence on program design and policy, including HCA and other state agencies, local government, federal government, non-profit and advocacy groups, contractors, and other entities. * Oversee and manage multiple, diverse assignments, track progress and achieve deadlines. * Develop program materials that are accurate, clear, concise, and comply with the agency's communication and style guide standards. * Complete analysis and make recommendations, including formal written reports and presentations, and informal program improvements. * Envision and develop program improvements, implement improvements and monitor for effectiveness. * A working knowledge of Washington State governmental structure and function of division, especially Medicaid policies, procedures, and services to ensure appropriate Medicaid services to participants of the division's programs. * Considerable working knowledge of state and federal laws, regulations, and procedures as they relate to Medicaid, health care reform and delivery of medical programs. * Considerable experience with software programs including work processing, spreadsheets, database, and flow charts. 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. 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, and persons of disability are less likely to apply for jobs unless they feel they meet every qualification as described in a job description. Persons over 40 years of age, disabled and Vietnam era veterans, as well as people of all sexual orientations and gender identities are also encouraged to apply. If you have any questions about the required qualifications or how your experience relates to them, please contact us at . Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Julie Laney at (360) 725.5130 or . 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. Subscribe to our weekly newsletter to receive a list of new job postings at HCA.