Medical Assistance Specialist 4 (MAS4/AHSO) Internal

Medical Assistance Specialist 4 (MAS4/AHSO) - Internal This opportunity is internal and available to current HCA employees only. This recruitment will be used to fill multiple positions. The Medical Assistance Specialist 4 serves as a lead worker supporting Washington State residents in accessing Medicaid, CHIP, and other state-funded programs, bringing expertise in eligibility policy to the Medical Eligibility Determination Services (MEDS) team. This role combines conducting hands-on eligibility determinations with training, auditing, and workflow oversight responsibilities. 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 organization's mission is to provide high quality health care through innovative health policies and purchasing strategies. The Apple Health Services and Operations (AHSO) Division works across the Health Care Authority (HCA) and in partnership with the health care community at local, state and federal levels, in order to develop and manage high quality, and evidence-based health care programs and purchase services that enhance Washington State's citizens' ability to access appropriate, quality health care.

About the position:

The Medical Assistance Specialist 4 supports the HCA mission to provide access to medical care for all eligible Washington citizens. The position serves as a lead worker in a team of Medical Assistance Specialists and determines initial eligibility and/or ongoing individual and family medical eligibility for Medicaid Title XIX, Children's Health Insurance Program (CHIP) Title XXI programs, and other Medicaid and state funded medical assistance programs available in Washington State. 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. This position reports to Olympia, WA. Frequency of onsite work will vary based on business and operational needs. All agency employees are required to report on-site in Olympia on their first and last days of employment to pick up and return state-issued equipment, regardless of telework status or location. Some of what you will do: Provide eligibility support and clarification to MAS-level staff determining initial eligibility and/or ongoing medical eligibility. Eligibility expert interprets policy and regulations, analyzes workflow and automated systems problems, devises and implements new and revised procedures, and monitors ongoing systems operations in the broader aspects of MEDS related system activities. Provide eligibility training for new staff to determine initial and/or ongoing eligibility for Health Care Authority medical programs. Provide system training, interviewing and workload management for new staff. Apply complex federal and state eligibility regulations published in WAC and RCW to specific household circumstances. Develop eligibility and system training for new and seasoned staff based on program changes and changes to eligibility. Develop and provide training on identified performance gaps. Use and manage multiple inter-dependent electronic systems including but not limited to the Automated Client Eligibility System (ACES), Provider One, Audit Plus, Microsoft Office, SOLQ, Document Management System (DMS), SEMS, TALX, DOH, and the Employment Security Department (ESD). Conduct internal program audits of new and experienced staff, identifying error trends and performance issues. Work with individual Take Charge providers to answer inquiries and resolve issues related to eligibility for the Take Charge Family Planning program. Assist supervisors and lower-level specialists in determining final disposition of complex eligibility cases. Monitor the ongoing activity of providers and clients that have been identified as deviating from the pre-described norms of practice. Monitor team workload and priorities. Support management directives. Maintain confidentiality in all interactions as appropriate.

Required qualifications:

Qualified candidates will satisfy one of the following options: Option 1: Bachelor's degree and Two (2) years of experience as defined below Option 2: Associate degree and Four (4) years of experience as defined below Option 3: Six (6) years of experience as defined below Option 4: One (1) year of experience as a Medical Assistance Specialist 3 Qualifying experience includes the following : Providing direct client services or counseling of customers in the areas of health insurance, disability, or other related health benefits; Public assistance eligibility determination; Health insurance premiums/claims processing, adjusting, and investigation; Other medical premiums/claims related experience.

Required competencies:

The ability to take action to learn and grow. The ability to take action to meet the needs of others.

Preferred qualifications:

ACES, HealthPlanFinder, MVP, Provider One and/or Barcode/DMS experience.

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 in separate files: 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. 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 HCAjobs@hca.wa.gov . Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Angel Matthews at angel.matthews@hca.wa.gov or 360-725-2038. 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.