[Hiring] Medical Assistance Specialist 4 @State of Washington

Role Description

This Medical Assistance Specialist 4 serves as a lead worker on the Foster Care and Adoption Services (FCAS) team 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. Ideal candidate will be familiar with the FCAS workload.

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.

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.

Duties

• 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.

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.

Benefits

• Meaningful work with friendly co-workers who care about those we serve
• A clear agency mission that drives our work and is person-centered
• A healthy work/life balance, including alternative/flexible schedules and mobile work options.
• A great total compensation and benefit package
• A safe, pleasant workplace in a convenient location with restaurants, and shopping nearby.
• And free parking!