WMS ($59,200 - $89,510 annually DOE)
Why work at the Health Care Authority (HCA)?
HCA employs about 300 people located in Lacey and Seattle. Our employees take pride in helping fellow state employees and Washington residents get information about health care coverage and keep that coverage. As recipients of state health coverage ourselves, we know wellness and peace of mind comes from affordable, accessible health care.
The Lacey office, located in Woodland Square Loop, sits in a park-like setting close to shopping, banking, restaurants, and St. Martin’s University. Employees enjoy free nearby parking. The location is close to Intercity Transit (I.T.) stops, and the state provides free unlimited I.T. passes for employees.
The Seattle office, located on 3rd Avenue near Pike, is close to shopping, banking, restaurants, Westlake Center, Pike Place Market and the waterfront. For additional information, go to http://www.downtownseattle.com
Employee Benefits
The state of Washington offers a comprehensive benefits package, including:
- Medical
- Dental
- Life insurance
- Long-Term Disability insurance
- Optional Long Term Care and Auto/Home insurance
- Optional Flexible Spending Account
- Optional Dependent Care Assistance programs
- Vacation, sick, military, and civil leave
- Eleven paid holidays per year
- A state retirement plan
- Optional credit unions and savings bonds
- Optional Deferred Compensation
About the HCA
HCA administers the following programs:
- Basic Health
- Community Health Services
- Health Technology Assessment Program
- Prescription Drug Program
- Public Employees Benefits Board (PEBB) Customer Service
- PEBB Plan Management - Administers two self-insured health plans:
- Washington Wellness
For more about our agency and its mission, visit our website.
HCA vigorously pursues diversity in the workforce. We encourage women, racial and ethnic minorities, people with disabilities, and disabled and Vietnam-era veterans to apply. People with disabilities who need help with the application process may call the HCA’s Human Resources Office at 360-923-2703. If you need this application in an alternative format (such as Braille or audio), please contact our Americans with Disabilities Act Coordinator at 360-923-2805 or TTY 360-923-2701.
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The Washington State Health Care Authority empowers you to make a difference!
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HCA is seeking candidates for a permanent opening in Seattle, Washington with the PEBB Plan Management division. This position is overtime exempt and is not covered by a union bargaining agreement. |
Essential Activities
Serve as a senior leader and clinical expert in the PEBB Plan Management (PPM) organization, reporting to the Assistant Administrator.
Direct vendor contract activity, support internal account managers, and provide clinical expertise and perspective to the PPM organization.
Participate in procurement and implementation of new vendors and services.
Ensure collaboration between benefit delivery, and other departments within PPM, the agency and with other stakeholders.
Account manager for programs and contracts with clinical impact.
Serve as the PPM Clinical Director, providing direct clinical support and expertise during the development of PEBB benefits, coverage, reimbursement strategies and policies. Answer clinical questions related to coverage, determinations of when content experts are needed for decisions, lead for contract review for clinical issues, implementation of new or changing issues.
Lead and coordinate PPM clinical meetings with vendors and work with vendor medical directors to ensure coordination of policy changes such as HTA decisions, legislative decisions, etc.
Participate in the annual development of benefit change recommendations for PEB Board consideration and other scheduled activities related to the annual PEBB procurement process.
Management of 4-8 staff within the benefit delivery system, varying from front line classified staff to high level management positions.
Required Qualifications
Current Washington health practitioner license (RN, Pharm D, MD, or other health care practitioner) AND a minimum of three years professional clinical work providing direct patient care in an evidence based medicine environment
Three years of health plan experience
Knowledge of health plan functions such as claims, preauthorization, medical review, and provider contracting
Minimum five years experience managing a diverse staff
Demonstration of excellent communication skills, both verbal and written
Two years experience working with or in the public sector
Strong leader
Confident decision-maker
Desired Qualifications
Undergraduate degree in a clinical or health related field.
Contract or account management experience with vendors, writing or responding to RFP's, contracts, vendor accountability, etc.
Experience reviewing, auditing, and analyzing health plan data or other types of health or medical information.
To apply, please submit:
- Resume Optional
- A letter of interest, telling us how you meet the qualifications listed.
- A completed Washington State application form, available at: http://www.dop.wa.gov/Pages/forms.aspx - Resume optional
- A minimum of three contacts for employment references, two supervisors and one peer or co-worker.
- The reference authorization form.
| You may submit these materials by mail, e-mail, or fax. | |
Mailing addressHealth Care AuthorityHuman Resources Office P.O. Box 42698 Olympia, WA 98504-2698 Contact informationPam Dickey360-923-2814 TTY 360-923-2703 |
E-mail address and faxhcajobs@hca.wa.govPlease use "PPM Benefit Delivery Systems" in the Subject line Fax: 360-923-2604 |
The Washington State Health Care Authority performs background investigations on all external applicants prior to an offer of employment. Your cooperation in providing the requested information is required to be considered for employment with our agency.
NOTICE REGARDING BACKGROUND INVESTIGATION
The Washington State Health Care Authority may obtain information about you from a consumer reporting agency for employment purposes. Thus, you may be the subject of a "consumer report" and/or an "investigative consumer report" which may include information about your character, general reputation, personal characteristics, and/or mode of living, credit standing, and which can involve personal interviews with sources such as your neighbors, friends, or associates. These reports may be obtained at any time after receipt of your authorization and, if you are hired, throughout your employment. You have the right, upon written request made within a reasonable time after receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report. Please be advised that the nature and scope of the most common form of investigative consumer report obtained with regard to applicants for employment is an investigation into your education, employment history, criminal history, and driving history conducted by ERS Northwest, Inc., PMB 727, 8002 NE Highway 99, Suite B, Vancouver, WA 98665. 1-800-500-5820. The scope of this notice and authorization is all-encompassing, however, allowing the Washington State Health Care Authority to obtain from any outside organization all manner of consumer reports and investigative consumer reports now and, if you are hired, throughout the course of your employment to the extent permitted by law. As a result, you should carefully consider whether to exercise your right to request disclosure of the nature and scope of any investigative consumer report.
Follow this link for more information regarding your rights under the Fair Credit Reporting Act. www.ftc.gov/credit.