All-Payer Claims Database Program Manager (WMS2/SPI)

Description All-Payer Claims Database Program Manager (WMS2/SPI) 71073027 The APCD Program Manager has the unique opportunity to drive major, systemic changes in healthcare affordability, policy, and public health transparency. This position is responsible for the state’s all‑payer health care claims database (WA‑APCD). The WA‑APCD is a highly secure, credible and frequently used data asset that provides cost transparency in health services, informs health care policy, and facilitates the advancement of medicine and public health. 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, & Innovation division (SPI) of the Health Care Authority (HCA) is statutorily directed to study all state‑purchased health care and 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 is responsible for the monitoring and management of the WA‑APCD program, using established program management principles, methods and practices. This includes establishing operational priorities, reviewing and approving budget allotments and expenditures for the $2.2 million annual budget, approving specifications and design requirement changes for the WA‑APCD, consulting as subject matter expert, and overseeing program progress and fulfillment of statutory objectives and requirements. The position supervises program support staff, oversees web/communications and database vendor contracts, and works with data submitters (private and public healthcare payers, including third‑party administrators), participating hospitals, outpatient facilities and clinic providers, state agencies, and other health care industry stakeholders in Washington and around the country on legislatively mandated WA‑APCD program activities. This position is eligible to telework but is frequently required to report on‑site to meet business needs. 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 on‑site 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 Develop and manage all aspects of WA‑APCD program engagement including planning, external vendor, data submitter, and provider relationships, budget, resources, and communications. Follow, implement, and refine systems and procedures to ensure WA‑APCD program efficiency, and long‑term stability for WA‑APCD data submission and data release program activities. Administer database and web/communications subcontracts and manage all contractual relationships. Represent the WA‑APCD to national and state (internal and external) health care stakeholders. Conduct WA‑APCD program financial sustainability, monitoring and reporting. Oversee WA‑APCD program operations and programmatic services. Assist in contract negotiations and renew agreements with Data Vendor and Web Vendor. Update and manage WA‑APCD program Data Use Agreements (DUA) and program Data Requests/Governance. Monitor data submission progress and work with private and public health care payers on policy related issues such as exemption request decision making. Monitor and report on performance against deliverables. Manage risks and issues. Create procedural documents, charters, reports, and other WA‑APCD program materials, as needed, to maintain WA‑APCD program structure. Lead WA‑APCD Program team Analytic Data Products and Services, including statutorily required Reports. Manage WA‑APCD program analysts. Administer Data Release Program. Qualifications Required qualifications: Option 1: Master’s degree from an accredited college or university in public health, public administration, data science, or related field. Three (3) years of experience applying senior project management skills working with large and complex healthcare database projects. Option 2: Bachelor’s degree from an accredited college or university in public health, public administration, data science, or related field. Five (5) years of experience applying senior project management skills working with large and complex healthcare database projects. Option 3: Nine (9) years of experience applying senior project management skills working with large and complex healthcare database projects. Required competencies: The ability to take action to learn and grow. The ability to take action to meet the needs of others. Ability to collaborate with various stakeholders and to determine project scope, deliverables, goals, risks, blockers, success measures, and to estimate needed resources. Plan, schedule, monitor, and report on activities related to the WA‑APCD, including subcontractor monitoring. Ability to explain complex or technical information using plain language, ask clarifying questions, and clearly and concisely emphasize key points. Ability to work in a fast‑paced environment with tight deadlines and a high degree of political sensitivity. Experience with federal and state processes, rule and HIPAA requirements. Ability to work effectively in a multi‑disciplinary team and independently. Excellent written and verbal communication skills. Preferred qualifications: Knowledge of historical context of Washington state health programs and the evolution of the WA‑APCD. High level of workload management including organization and prioritization of tasks. Prior experience analyzing healthcare claims data. Experience using data visualization tools such as Tableau and Power BI. HCA is an equal opportunity employer. All applicants with a legal right to work in the United States are encouraged to apply. The Washington State Health Care Authority (HCA) is an E‑Verify employer. #J-18808-Ljbffr