Director, Medicaid Payment Program

Director, Medicaid Payment ProgramsBenefits- Medical, Dental, Vision, Life, LTD, FSA, HSA, 401k safe harbor, 2 plus weeks of vacation and Wellness Week between Christmas and New Years, 11 holidays, and transportation allowance.Hybrid Work OpportunityPOSITION SUMMARY:Washington State’s Medicaid Directed Payment Program provides essential funding for hospitals to serve Medicaid patients, who are among the state’s most vulnerable residents. The Director of the Medicaid Payment Program is an integral part of the success of the program for hospitals across Washington State. This position provides an opportunity for someone with strong finance/accounting and analytical skills to make an important contribution to the health of our communities.The Director of the Medicaid Payment Programs is a member of WSHA’s Safety Net Assessment Program (SNAP) team. This position leads SNAP operations, including development of member specific reports and analysis, and prepares member communications on SNAP financial and related matters. This work includes the Prospective Payment System/Critical Access Hospital (PPS/CAH) Assessment Program with 88 hospitals and the Designated Public Hospital District (PHD) intergovernmental transfer Program with 8 hospitals. This position leads the member SNAP accounting, budgeting and financial projections work. The position works closely with CFO and consultants on performing analysis and verifying the accuracy of the projections. The position is responsible for sending timely SNAP information to members and answering SNAP financial questions received from members. The position also works closely with the CFO to send quarterly payment schedules and to project SNAP net benefits for current and next calendar year for each of the participating organizations. The position also works with hospital and state agency staff on administration of SNAP and represents WSHA and its members to external audiences.ESSENTIAL DUTIES AND RESPONSIBILITIES:Works with CFO on SNAP operations including completing and sending quarterly payment/net benefit summaries to each of the 60 participating organizations. For organizations with more than one hospital, summaries are provided for each hospital.Serves as a member of the internal SNAP team. Participates in internal and Washington State Health Care Authority (HCA) bi-weekly SNAP meetings. Drafts agenda for the internal SNAP team meetings and assists with the agenda for HCA bi-weekly SNAP meetings.Assists with the calculation of each participating member’s estimated net benefit for current year with the assistance of the CFO and consultants while working with each participating organization. Communicates any significant changes with CFO to members.Maintains a database of financial models for PPS/CAH program and Designated PHD program.Assists members in projecting the next calendar year’s estimated net benefit each October. This is for member budgets and financial planning. For members with a June 30 year, assist with their budgeting and cash flow projections as needed.Reviews and assists with calculation of annual PPS/CAH assessments for each member working with HCA, Milliman, WSHA’s consultant and the CFO each year in the fourth quarter.Maintains an electronic file for each member to store all communications and schedules WSHA provides about SNAP.Answers member questions on SNAP with the assistance of CFO as needed.Drafts and sends quarterly SNAP update electronic newsletter to participating members after review and approval from the internal SNAP team.Provides education to member personnel on how SNAP works on at least an annual basis for both the PPS/CAH program and Designated PHD program. Orients new member personnel to the SNAP Program as needed.Maintains a current SNAP contact list for each participating member in WSHA Connect.Develops and maintains a positive relationship with state Health Care Authority technical staff.Other duties required to support program functions and success.Other duties as time allows:Assists with financial analysis of the quarterly member financial survey.During the state legislative session assists with financial analysis of proposed legislation and budgets.Assists with the collection and financial analysis of the AHA Vitality Payer Scorecard data that provides key information about insurer practices for hospital care.Other projects and duties as assigned.QUALIFICATIONS:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.Education/Experience:Bachelor's degree in accounting, finance or related field is required, plus a minimum of three years’ recent experience in hospital/health care accounting and finance. Additionally, demonstrated positive client relations and project management.Skills & Abilities:Demonstrated ability model financial projections using assumptions.Ability to develop, lead, and participate in projects and programs.Preference and ability to work collaboratively with others to resolve issues and complete projects.Excellent customer/member relations skills as well as verbal and written communication skills.Strong project management and organizational skills.Self-starter with strong analytical skills.Ability to understand the Medicaid program including billing and quality improvement metrics.Computer Skills:Strong computer and data management skills, including proficiency with the Microsoft Office suite, especially Excel, and ability to produce graphs, charts, and spreadsheets.Demonstrated experience with database management.Ability to gather, interpret and analyze data using computer software.PHYSICAL DEMANDS AND WORK ENVIRONMENT:The physical demands and work environment described below represent the activities and surroundings of the positions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.This is a full-time position associated with successful sustainability of the Medicaid SNAP programs. It is a hybrid work schedule with work from home and in office attendance with a minimum of 2 days a week out of home (in the office or in the field). Hours of work could extend beyond the standard business day including, but not limited to during the state legislative session or for member financial information needs. Position requires frequent use of computer and exposure to normal physical office environment. Work when in the office is typically performed in an environment with a moderate noise level. The employee is frequently required to talk and hear on the telephone, in video conferences and in person with individuals and groups. The employee is required to read and respond to documents in hard copy and electronic form. The position may require some travel within Washington State to member facilities or other off-site locations and on occasion, overnight travel is necessitated. #J-18808-Ljbffr Washington State Hospital Association