L&I Health Services Analysis Program Manager

Our Mission:

Keep Washington Safe and Working!

Our Values:

Customer Focus, One L&I, Respect, Diversity, Equity and Inclusion, Learning and Growth, Reliability The salary offer will be based on the candidate's job-related skills, experience and training. The target pay range of consideration for this exempt position is typically $82,344- $146,784 annually. The full band pay range is $104,772- $146,784 annually. Why work at L&I The Department of Labor & Industries (L&I) is a diverse state agency dedicated to the safety, health, and security of Washington's workers. We help employers meet safety and health standards and inspect workplaces when alerted to hazards. As administrators of the state's workers' compensation system, we are similar to a large insurance company providing medical and limited wage-replacement coverage to workers who suffer job-related injuries and illness. Our rules and enforcement programs help ensure workers are paid what they are owed, that children and teens' work hours are limited, and that consumers are protected from unsound business practices. Insurance Services is the largest division within the agency and administers one of the premier workers' compensation organizations in the nation serving over 3.8 million employees working for 260,000 employers. Health Services Analysis (HSA) is responsible for L&I's health care provider network (RCW 51.36.010). This includes the implementation and management of standards for qualification and performance of providers who treat injured workers, as well as enrolling qualified providers in a statewide workers' compensation medical provider network. This includes credentialing providers, monitoring health care provider quality and performance, managing medical and spending through fee schedules and payment policies, paying medical bills, supporting providers through a call center and through outreach activities, managing language access services to ensure workers can effectively communicate with health care and vocational providers, and increasing providers' use of occupational health best practices. Take a look at this brief video and learn more about why L&I is an employer of choice. Work-life balance is a priority at L&I. We support a hybrid work model and offer flexible work schedules which may include 4/10's, 9/80's or 5/8's. You will need to attend in-person activities, meetings or events as needed for business purposes. This position can be located in any of our L&I service locations statewide. The successful incumbent must reside in Washington, Idaho or Oregon. Employees will be responsible for travel and expense from their resistance to their assigned office. We offer great benefits which include paid leave, tuition imbursement, infants at work, generous retirement package and much more. Select on the "Benefits" tab to learn more. Job Highlights The HSA Program Manager's focus is to reduce disability and help injured workers heal and return to work by ensuring delivery of effective health care treatment and access to quality providers. The Program Manager is responsible for maintaining efficient oversight of medical payments, treatment and quality of services and medical providers. The Program Manager is responsible for controlling medical cost growth. By overseeing timely and accurate payment of medical bills totally approximately $600 million per year. The program establishes and maintains medical fee schedules that are fair and competitive to ensure providers are willing to treat injured workers and workers have timely and equitable access to necessary medical services. The Program Manager leads a program of roughly 125 employees through: Developing an overall vision and strategic measures to ensure access to medical care and provider adoption of occupational health best practices. Working with IT and contracted vendors to ensure that HSA technology platforms effectively support system users and can produce data to assess program as well as provider performance. Overseeing contracted research and pilots to develop and test emerging best practices that span the full period of worker recovery. Financial and operational integrity of Medical Aid Fund payments and medical bill payment systems. Managing timely and accurate bill payment and Provider Hotline responses to inquiries.

Required:

5 years of experience with senior leadership in program and/or operational management which includes responsibility for fiscal, project and personnel management. 2 years of experience managing multi-million-dollar budgets, including budget decisions involving allocation of people and contract resources to achieve strategic plan goals, business area objectives and track performance measures.

LEADERSHIP SKILLS

Demonstrated ability to develop, lead, and mentor professional staff. Demonstrated ability to make resource (people, contract, budget) decisions to achieve strategic plan goals, business area objectives, and track performance.

COMMUNICATION SKILLS

Ability to write reports, business correspondence, and procedures. Ability to effectively present information and respond to questions from leadership, employees, clients, customers, legislators, and the general public. Demonstrated ability in presenting to large audiences, facilitating meetings, and engaging in interpersonal interactions.

EQUITY COMPETENCIES

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

EDUCATION 6

years equivalent experience in lieu of a degree. Master's degree in public administration, law, business administration, health care administration, or closely related field.

Desired:

Health care purchasing, health insurance, workers' compensation medical benefit management, or comparable experience. Work in Washington State is a plus. Demonstrated ability to develop, lead, and mentor professional staff. Experience in applying principles of provider network management - credentialing, policy development, payment, provider support, quality assurance. Experience working within healthcare systems and provider organizations Experience or knowledge with medical coding compliance and provider review and potential regulatory actions Current experience and expertise in health care cost analysis, health care management, provider reimbursement, cost containment, medical payment, contracting, and utilization review or quality assurance. Expertise in quantitative analysis, basic research methods, performance measurement, and program evaluation. Understanding and appreciation for the role of internal and external audit programs in identifying and reducing financial risk. Experience managing a complex organization and operating environment (unionized workforce a plus). Experience managing performance-based contracts and developing collaborative relationships with external partners. Complete the online application and attach the following documents. Your application may be considered incomplete if you do not include the following: A cover letter describing your experience, skills and contributions you will bring to this role. A current resume detailing applicable experience and education. Do not attach or place any medical information in the application, resume, or cover letter. If you do, we must reject your application to safeguard others from receiving your confidential information. Learn more about our hiring process on L&I's website . If you need an accommodation for the application or hiring process, please email or call us at 360-902-5700 . TTY users should first call 711 to access the Washington Relay Service. L&I is an equal opportunity employer and doesn't discriminate based on race, color, religion, gender, gender identity or expression, sexual orientation, pregnancy, national origin, genetics, disability, age or veteran status . Background Check Notice Prior to placement in a position at L&I, a background check, including criminal history record will be conducted. The results might not disqualify candidates. L&I understands some situations may require further explanation. In these situations, candidates will have the opportunity to talk with the L&I Assistant Director of the Office of Human Resources. Other information If you are asked to travel, you must have a valid unrestricted driver's license and have insurance if driving a privately owned vehicle on state business. Candidates who are offered a job with L&I must possess work authorization that does not require sponsorship by the employer for a visa now or in the future. L&I complies with the employment eligibility verification requirements of the federal employment eligibility verification form, I-9. The selected candidate must be able to provide proof of identity and eligibility to work in the United States consistent with the requirements of that form on the first day of employment. Veterans Preference Applicants wishing to claim Veterans Preference should attach to their application a copy of their DD-214 (Member 4 copy), NGB 22, or signed verification of service letter from the United States Department of Veterans Affairs. Please blackout any personally identifiable data such as Social Security numbers and Date of Birth. For further information, contact L&I's Talent team . For more Information If you have any questions regarding this job posting, program, or the agency, please contact Sally Elliott , Talent and Belonging Manager. To receive more information on opportunities at L&I sign up for GovDelivery and select L&I job alerts.