Care Coordination Quality Assurance Administrator (Operations & Policy Analyst 3)

Initial Posting Date: 10/18/2024

Application Deadline: 10/28/2024

Agency: Oregon Health Authority

Salary Range: $5,747 - $8,831

Position Type: Employee

Position Title: Care Coordination Quality Assurance Administrator (Operations & Policy Analyst 3)

Job Description:

Do you have experience supporting the implementation of contracts, policies, projects or programs that seek to promote equitable access to care and reduce health disparities? Are you passionate about designing quality assurance mechanisms that translate to effective and streamlined care coordination, supportive care experience and improved health outcomes? We look forward to hearing from you!

This posting will be used to fill one (1) permanent, full-time position. The position is classified and is represented by a union.

Work Location: Salem/Marion or Portland/Multnomah; hybrid position

What you will do!

The purpose of the Fee For Service Contracts Quality Assurance Administrator position is to center Medicaid Fee-for-Service (FFS) members in the development of FFS care coordination contract administration policy and quality improvement processes designed to establish statewide FFS care coordination contract administration standards. The development of these statewide FFS contract administration standards will include research into current federal trends and statewide Coordinated Care Organization (CCO) contract administration practices, the development of FFS care coordination Oregon Administrative Rules (OARs), the creation of criteria for measuring the effectiveness of FFS care coordination contract administration, and the development of administrative quality improvement processes through which the state can continuously improve the federally mandated standard of healthcare service for Oregonians.

FFS care coordination contracts will be administered to a third-party administrator (TPA), which will provide comprehensive, person-centered care for Medicaid members, including behavioral health, physical health, oral health, and Medicaid 1115 Waiver Health Related Social Needs (HRSN) services. The TPA will also include care coordination for an expanded group of members such as individuals in incarcerated settings and Substance Use Disorder 1115 Waiver beneficiaries. In working closely with the TPA, and the FFS Quality Assurance team, this OPA3 position will help oversee the supervision of various contracts, oversee the provider network manager, and network adequacy across the Medicaid FFS services. This role will provide data analysis for reporting requirements as set by the Centers for Medicare and Medicaid Services (CMS). The person in this position is responsible for contract accountability and metrics and provider network adequacy.

To establish criteria for measuring the effectiveness of statewide FFS contract administration, this position will help facilitate and gather data and analyzes collected to monitor and manage FFS program compliance. This work is done in collaboration with various entities and partners, including but not limited to behavioral, oral, and physical health providers, the Federal Centers for Medicare and Medicaid Services (CMS), the Oregon Legislature, the Health System Division, OHA’s Office of Actuarial and Fiscal Analysis, Budget Unit, Health Policy and Analytics, and the Public Health Division.

OHA values service excellence, leadership, integrity, health equity and partnership and has a strategic goal to end all health inequities by 2030.

The OHA mission is helping people and communities achieve optimum physical, mental, and social well-being through partnership, prevention and access to quality, affordable health care. OHA’s work is organized into three broad goals: Improve the lifelong health of all Oregonians, increase the quality, reliability, and availability of care for all Oregonians and lower or contain the cost of care so it is affordable to everyone.

What's in it for you?
Oregon Health Authority is a team of passionate individuals working to promote health across the lifespan of individuals, families, and communities. We value and support unique perspectives using a trauma-informed approach and aim to reflect these values in our hiring practices, professional development, and workplace.

• We offer exceptional medical, vision and dental benefits packages for you and your qualified family members, with very low monthly out-of-pocket costs.
• Paid Leave Days:
  • 11 paid holidays each year
  • 3 additional paid "Personal Business Days" each year
  • 8 hours of paid sick leave accumulated every month
  • Progressive vacation leave accrual with increases every 5 years
• Pension and retirement programs
• Optional benefits include short-term disability, long-term disability, deferred compensation savings program, and flexible spending accounts for health care and childcare expenses.
• Click here to learn more about State of Oregon benefits.

WHAT WE ARE LOOKING FOR:

Minimum Qualifications

Any combination of experience or education equivalent to seven years of experience professional-level evaluative, analytical and planning work.

NOTE:

A degree in Business or Public Administration, Behavioral or Social Sciences, or a degree related to the Health Systems or Public Health will substitute for some required experience:

• An Associate’s Degree is equal to 18 months of experience.
• A Bachelor's Degree is equal to three years of experience.
• A Master’s Degree is equal to four years of experience.
• A Doctorate Degree is equal to five years of experience.

Desired Attributes

• Preference may be given for the ability to read, write, speak and interpret English and one of the 5 most common languages in Oregon other than English (Spanish, Vietnamese, Chinese, Russian, and Korean) with full proficiency.
• Experience in advancing health equity, including effective delivery of culturally responsive and inclusive services, evidence of ongoing development of personal cultural awareness and humility, and knowledge of social determinants of health and their impacts on health outcomes.
• Experience supporting the development and implementation of policies, projects and programs at the community, state, and/or national level that advance health equity, address systemic health disparities, and elevate the voice of community and those with lived experience.
• Experience factoring in the perspectives of diverse populations most harmed by social injustice and inequities including communities of color, immigrant groups, the disability and neurodivergent communities, veterans, older adults, individuals identifying as LGBTQIA+ and other communities that have been traditionally marginalized.
• Specific knowledge of Oregon Administrative Rules and Oregon Revised Statutes, other applicable regulations, and program requirements.
• Knowledge of health services delivery systems, particularly the Oregon Health Plan/ Medicaid administration in Oregon, and experience in working with Community Mental Health Programs, Behavioral Health Service Providers, Coordinated Care Organizations or other managed care entities and their leadership to guide operations and policies.
• Experience interpreting, applying and enforcing relevant federal and state Medicaid laws and regulations, including Medicaid Managed Care regulations.
• Knowledge about contracts/interagency agreement administration, procurement, grant administration, and project management within the context of Oregon state government (e.g. OHA/ODHS) or other complex health services delivery organizations.
• Ability to provide organizational leadership to support inter-and cross-agency collaboration and systems-wide changes that facilitate advocacy, equity, and client-centered policies and solutions.
• Specific knowledge of business and management principles involved in strategic planning, resource allocation, leadership technique, iterative design, and continuous improvement strategies.
• Demonstrated project management experience, including ability to effectively manage multiple project timelines, contracts, plans, and deliverables.
• Experience and knowledge of qualitative and quantitative techniques for analyzing and measuring the effectiveness, efficiency, and productivity of administrative and technical programs.
• Strong communication skills across a variety of forms that demonstrate the ability to facilitate appreciative inquiry, foster trust and transparency, and promote human-centered change management.
• Ability to navigate complex relationships; ability to demonstrate collaborative problem-solving skills, consensus-building and solution driven approaches.
• Ability to demonstrate advanced Microsoft Excel, Word, PowerPoint, and Outlook skillset; and skilled use of collaboration tools such as Microsoft Teams, SharePoint, and Smartsheet.
• Demonstrates skills in the following areas:
  • Community and Partner Engagement
  • Policy Advisement
  • Performance / Process / Quality Improvement
  • Systems and Organizational Improvement
  • Program Design, Implementation, and Evaluation
  • Data Synthesis, Analysis and Reporting
  • Contract Administration
  • Project Management
  • Expert level Technical Assistance
  • Strong Oral and Written Communication

How to apply:

• Complete the online application
• Attach a Cover Letter, no more than 2 pages, specifically focused on your qualifications for this position as identified in the Desired Attributes section of this announcement.
• Please ensure you’ve provided a thorough and updated application as it pertains to the position for which you are applying. Update professional, educational, voluntary, and personal experience on your resume. Your application materials will be used to determine salary based on a pay equity assessment. For further information, please visit the Pay Equity Project homepage.

Questions/Need Help?

If you need assistance to participate in the application process, including an accommodation request under the American with Disabilities Act contact: Stephanie Mitchell at Voice: (503-979-7679) (TTY 711) or Email: .

TTY users may dial 711 or 1-800-735-2900.

For Workday technical support dial 1-855-524-5627.

Additional Information

• Please monitor your Workday account, as all communication will be sent to your Workday account. You must have a valid e-mail address to apply.
• Candidates gathered from this job announcement may be used to fill future vacancies.
• If you are a veteran, you may receive preference. Click here for more information about veterans’ preference. If you checked that you are a veteran, we will ask you for your documents later in the process.
• Oregon Health Authority (OHA) does not offer VISA sponsorship. Within three days of hire, you will be required to complete the US Department of Homeland Security’s I-9 form confirming authorization to work in the United States. OHA is an E-Verify employer and will use E-Verify to confirm that hires are authorized to work in the United States.
• If you are offered employment, the offer will be contingent upon the outcome of an abuse check, criminal records check and driving records check, and the information shall be shared with the Oregon Health Authority (OHA), Office of Human Resources (OHR). Any criminal or founded abuse history will be reviewed and could result in the withdrawal of the offer or termination of employment.
• Please only attach documents that are related to the position. Additional documents that are attached will not be reviewed.
• Attention current State of Oregon employees : To apply for posted positions, please close this window and log into your Workday account and apply through the Career worklet.
• Applicant Help and Support webpage

The Oregon Health Authority is committed to fair employment practices and non-discrimination, including pay equity for all employees. We do not discriminate on the basis of protected class (race, sex, veteran status, disability, age, color, religion, national origin, marital status, sexual orientation) in the payment of wages or screen applicants on the basis of their current or past compensation. We determine salary by completing a review of your application materials to evaluate your related education, experience, and training for this position.

The Oregon Health Authority is an equal opportunity, affirmative action employer committed to work force diversity and anti-racism.