RHT Payment Model Manager (WMS2/SPI) - Project

RHT Payment Model Manager (WMS2/SPI) - Project 71113910 This is a project position funded through 10/30/2030. As the Rural Health Transformation (RHT) Payment Model Manager, you will lead the design of an alternative payment model aimed at creating long-term sustainability for rural hospitals and providers across Washington State. You will manage a high-profile contract with the Rural Health Redesign Center, engage with a broad range of partners (Tribes, payers, and rural hospitals), and serve as the expert on payment model requirements with federal partners. 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 Strategy, Policy, and Innovation division (SPI) of the Health Care Authority (HCA) is statutorily directed to study all state-purchased health care, alternative health care delivery systems and strategies for the procurement of health services, and to coordinate state agency efforts to develop and implement uniform policies across state purchased health care programs. SPI serves as the focal point for coordinating the agency’s strategy, affordability, and health policy efforts. The division is structured to provide expert direction, consultation, and support for these activities. SPI is responsible for driving policy design, development and implementation of health reform, and health transformation activities and program development and refinements for all programs. About the position: This position informs and guides the RHT initiative 1.2 as outlined in the RHT grant application, and oversees the design of an alternative payment model for long-term sustainability, and leads and manages the Rural Health Redesign Center contract. The incumbent will provide policy direction, monitor the progress of contracts and grants, and will solicit and oversee broad cross-state engagement to inform and guide initiative policy direction. The position reports to the RHT Director. This position is eligible to telework but is occasionally required to report on-site to meet business need. 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: • Direct and manage the contract with Rural Health Redesign Center, which will include regular meetings, developing and refining project scope and deliverables, providing additional guidance to ensure project goals and work products meet expectations, and limited travel. • Plan, direct/coordinate projects, and resources to support policy research, program development and implementation of federal and/or state health policy initiatives, with specific focus on RHT Initiative 1.2. Create documents to support these requests and the ongoing negotiation of federal financial assistance and contract planning. • Engage with internal and external stakeholders about payment model development, including but not limited to rural hospitals, payers, advocacy groups, and HCA’s Clinical Quality and Finance Divisions. • Serve as the subject matter expert and lead on all payment model requirements in the RHT Cooperative Agreement/terms and conditions with CMS and ensure compliance. • Engage with HCA’s Office of Tribal Affairs to coordinate engagement with Tribes and Tribal providers in the design of sustainable payment models. • Lead efforts to identify any legislative or statutory changes necessary to implement Alternative Payment Models (APM) and develop agreements with payers governing APM alignment and data sharing, including Business Associate Agreements and other requirements. • Research health care trends, reform, innovative models, and connect with counterparts in other states on these items to find evidence-based policy and lessons learned for the development of Washington’s RHT alternative payment model. • Provide strategic guidance for RHT leadership and team, including the ways in which RHT initiatives connect to each other and to existing state programs. Required qualifications: Qualifying candidates will meet one of the following criteria options: Option 1: Master’s degree or higher in a health policy related field or equivalent and five (5) or more years of the experience below Option 2: Bachelor's degree in a health policy related field or equivalent and seven (7) years of the experience below Option 3: Eleven (11) years of the experience listed below The required experience includes: • Progressively responsible project management experience in health coverage policy and program development. • Professional use of research, data, and limited resources. • Analysis of other state demonstrations, used to formulate and advise decision-making, issue resolution, and policy development. • Broad knowledge of the health care industry, payers (commercial, Medicare, and Medicaid), and other federal and state laws affecting the rural health care system. • Demonstrated experience in successfully managing complex health care related projects involving multiple partners and stakeholders, and in making presentations to external audiences on challenging policy concepts. Required competencies: • The ability to take action to learn and grow. • The ability to take action to meet the needs of others. Preferred qualifications: • Advanced degree in law or health policy. • Experience working with alternative payment models. Ability to write and develop successful grant and other funding applications to meet Washington State’s needs. • Knowledge of historical context of Washington State health policymaking and evolution of federal law impacting low-income populations, including Title XIX (Medicaid), national health reform and Washington’s Tribes. • Ability to conduct research projects requiring utilization of data and statistics. • Experience in systems thinking and planning. 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 [email protected] with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Lisa Fleming at (360) 725-1723 or [email protected] 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.