Forecast, Finance & Managed Care Rates Unit Manager

Forecast, Finance & Managed Care Rates Unit Manager (WMS2/FS)

71081604

This role makes a real difference in the lives of more than 2.5 million of your community members by playing a critical part in managing the vast financial resources entrusted to the Washington State Health Care Authority (HCA). In the course of their work, the incumbent will influence the state legislative and budgeting process, activities related to the annual managed care rate setting process, and the financial analysis of in-house analytics and third-party actuarial staff and consultants. Come help us revolutionize healthcare!

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 Financial Services Division (FSD) works with a variety of external stakeholders and customers to provide financial services and agency-wide financial management for both Medicaid and PEBB, specifically managing an annual operating budget of approximately $12 billion. This division maintains close working relationships with agency program, policy, and clinical divisions to ensure financially sound implementation and monitoring of program strategies. It is also accountable to the Governor and legislature in ensuring HCA operates within its overall agency budget.

About the position:
The Forecast, Finance & Managed Care Rates Unit Manager (WMS) is responsible for supporting the development of Medicaid Managed Care rates, overseeing the expenditure forecast process, and ensuring the timely completion of off-cycle managed care payments and gross adjustments. This position is responsible managing a team of staff to develop financial models, projections, and strategies to ensure sound financial management and operations of Medicaid programs and services. This work requires detailed knowledge and understanding of multiple program areas from legislative, regulatory, budget, and technical perspectives.  The incumbent must be able to train and mentor staff and is responsible for the activities and work products produced by this unit.

This position is eligible to telework but is required to report on-site at least once a week to meet business needs. Some travel may be required and is typically local to meet with internal and external clients, conduct businesses, attend or provide training. 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. Frequency of onsite work will vary based on business and operational needs. HCA may choose, but is not required, to support out-of-state telework on a case-by-case basis.

Duties

Some of what you will do:

Apple Health Managed Care Rates and Contracts

• Work with contracted actuaries to set AH and behavioral health capitated rates and develop/monitor compliance with the financial portions of associated contracts with managed care organizations.
• Coordinate and communicate with OFM and legislative partners on the results and implications of the Medicaid Fee-For-Service (FFS) and managed care (MC) rate setting processes and HCA policy decisions related to elements of the MC finance contract requirements (risk adjustment, risk margins, risk corridor/gain sharing, MC carve-outs, MC case payments and payment bundles, etc.).

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Medicaid Expenditure Forecast

• Oversee the coordination with other Financial Services Sections and external stakeholders such as the Legislature and OFM to research and inform changes impacting the Medicaid forecast.
• Oversee the fiscal input from various FSD staff in calculating forecast step increases/decreases affecting the funding levels for forecasted programs. These steps are essential in the development of the accurate forecast and budget for the entire Medicaid program.

Financial Management, Fiscal Impact, and Decision Support

• Oversee the creation of financial models and determine the fiscal impacts of legislative, policy, or rulemaking proposals put forth by the HCA or state or federal legislative bodies related to Medicaid managed care, including alternative scenarios if appropriate.
• Lead the development of modeling and strategies for sound fiscal projections to ensure adequate funding for agency programs.

Coordination with Authorizing Environment, Stakeholders, Partners, and HCA Programs/Units

• Coordinate with fiscal and programmatic staff internal and external to the HCA to ensure 1) the accuracy of data and information presented in agency biennial and supplemental funding proposals and 2) that budget policy objectives are met while furthering the strategic goals of the HCA.
• Communicate and coordinate with external and other internal agency staff, OFM, and legislative staff, and others as necessary on development of HCA or interagency proposals and analyses.

Supervising, Training and Management of Staff

• Manage all aspects of staff recruitment, on-boarding and training of new staff.
• Manage, coach and mentor staff in the Forecast, Finance & MC Rates Unit responsible for carrying out the objectives of the assigned programs.

Qualifications

Required qualifications:

Required Competencies

Analytic & Technical Skills

• Knowledge of Managed Care, Medicaid, and Medicare payment policies.
• Knowledge of federal Medicaid and Medicare statute (USC) codes (CFR), Medicaid State Plan, state laws (RCW), and regulations (WAC) that pertain to reimbursement and qualifications for Medicaid reimbursement.
• Knowledge of Managed Care and Fee for Service rate setting.
• Ability to learn quickly.
• Previous experience with large budget responsibilities.
• Ability to see both big picture and minute budget data details.
• Expert level skill with Microsoft Excel and working knowledge of designing complex modeling, structuring ad-hoc data for use in pivot tables and composing nested formulas.
• Ability to creatively use resources to create and document work processes and analytical tools.
• Ability to analyze data, identify data needs, develop problem solving strategies, support ideas using data as evidence, develop goals and priorities, and establish benchmarks.
• Ability to analyze and research the differences among budgeted and forecasted expenditures and actual expenditures and effectively communicate the reason for the differences.
• Analytical skills for financial research and modeling in complex multi-system environment.

Communication Skills

Effective verbal and written communication skills, including the ability to translate complex financial/analytical information for non-financial/analytical audiences.

Experience communicating with an array of audiences, ranging from staff with little financial background to elected government officials and federal auditors.

Ability to coordinate and build consensus among internal/external stakeholders toward the development of departmental and legislative initiatives.

Ability to develop and review complex written materials and provide detailed policy analysis. 

Management Skills

• Ability to effectively delegate responsibilities
• Ability to train and mentor staff 
• Experience managing and reviewing work to ensure quality

Required Education and Experience

Qualifying candidates will also meet one of the following criteria options:

Option 1: 

• A bachelor’s degree in: Business, Public Administration, Accounting, Mathematics, Economics, Statistics, or another quantitative field.
• Three (3) or more years of recent professional experience in a financial or analytical field.

Option 2:

• An associates degree in: Business, Public Administration, Accounting, Mathematics, Economics, Statistics, or another quantitative field.
• Five (5) or more years of recent professional experience in a financial or analytical field.

Option 3:

• Seven (7) or more years of recent professional experience in a financial or analytical field.  
   

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:

• 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. 

Supplemental Information

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.
• Tuition reimbursement
• 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

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.

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