Community Health Plan of Washington · 1 day ago
State Programs Contract Specialist
Seattle, Washington, United States
Full-time
Hybrid
Entry, Mid Level
$29.20/hr - $43.50/hr
2+ years expCommunity Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. This role provides project coordination and administrative support within the Compliance department, focusing on contract management activities related to Washington state Medicaid Programs.
Health Care
Responsibilities
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 (TEAMonitor) 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 monitoring of State Program project management work in-process and operational business owner activities. This includes outreach and management of deliverables to ensure deadlines are met
Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion
Qualification
Required
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 lifecycles 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
Knowledge and understanding of managed care environment, preferably with state managed Medicaid program(s) a plus
Excellent analytical and critical thinking skills
Excellent communication skills with internal and external stakeholders
Ability to communicate clearly and effectively in both verbal and written form
Ability to effectively partner across teams to analyze complex problems and implement solutions
Ability to comprehend and interpret regulatory/contract language and communicate regulatory expectations to stakeholders
Ability to be organized, methodical and detail oriented, and can plan, organize, and prioritize the work
Proficient skills with Microsoft Office products such as Word, Excel, Outlook, and Adobe Acrobat
Complete and successfully pass a criminal background check
Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency
Vaccination requirement (CHPW offers a process for medical or religious exemptions)
Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation
Benefits
Medical, Prescription, Dental, and Vision
Telehealth app
Flexible Spending Accounts, Health Savings Accounts
Basic Life AD&D, Short and Long-Term Disability
Voluntary Life, Critical Care, and Long-Term Care Insurance
401(k) Retirement and generous employer match
Employee Assistance Program and Mental Fitness app
Financial Coaching, Identity Theft Protection
Time off including PTO accrual starting at 17 days per year.
40 hours Community Service volunteer time
10 standard holidays, 2 floating holidays
Compassion time off, jury duty pay.
Company
Community Health Plan of Washington
For over 30 years, Community Health Plan of Washington (CHPW) has been providing quality health care to Washington families and supporting your choices for health care.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Leanne Berge
Chief Executive Officer
Stacy Kessel, CPA
Chief Financial Officer
Recent News
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