L&I Payment Policy and Provider Support Manager

Our Mission: Keep Washington Safe and Working! Our Values: Customer Focus, One L&I, Respect, Diversity, Equity and Inclusion, Learning and Growth, Reliability

*** The Target Pay Range typically considered for this position is $88,632 - $126,276 (Range of Consideration) annually. The Full Pay Range for this WMS Band is $72,420 - $132,924 (Full band range) annually. Compensation decisions are determined using factors such as job-related skills, experience, and education or training. We will consider your individual qualifications, should we make you an offer of employment.

The Department of Labor & Industries is looking for a Payment Policy & Provider Support Manager. This position is located in the Health Services Analysis (HSA) program within Insurance Services. HSA’s main function is to pay for medical services to treat injured workers and handle all aspects of the department’s business relationships with the healthcare providers who provide those services. HSA’s work is very closely connected with the work done by the Office of the Medical Director on coverage policies, treatment guidelines, and other clinical policies. HSA’s mission is to “ensure worker access to high-quality care.” This position reports to the HSA Program Manager and directs 20 professional staff in two units focused on payment policy/fee schedules, provider support and outreach, as well as an IT Application Developer for web support, an Administrative Regulations Analyst 4, and a Data Science & Informatics Specialist serving as the program’s data steward and data analysis lead. The Payment Policy & Provider Support manager is primarily responsible for maintaining the integrity of the Medical Aid Fund. The manager engages L&I management and business & labor stakeholders on matters related to improving the access, utilization, cost, and/or quality of workers’ compensation health care.

Some of what you will do:

• Hire, Supervise, mentor, and coach professional staff
• Prioritize and support staff assignments by providing and assigning resources, assist with problem resolution, and establish priorities
• Adapt to changing business needs, conditions, and work activities
• Make presentations to internal and external audiences
• Adapt to changing business needs, conditions, and work activities
• Represent staff and the department on inter-agency teams and external groups
• Conduct legislative bill analysis
• Develop, encourage, and support staff use of up-to-date knowledge/awareness of health care payment method trends, and issues related to access to healthcare
• Allocates funds for travel and training allotments for the unit
• Makes recommendations to executive leadership on annual payment updates for professional and facility services, adopted through annual rule making
• Engages with external customers including state hospital and associations representing medical professionals to reach consensus on L&I payment policy
• Works closely with other managers from Insurance Services program and HSA to ensure coordination and accuracy of content
• Responsible for establishing innovative payment policies for healthcare services

Required Bachelor’s degree in public administration, health administration, business, public health, or related field OR Demonstrated competency working in at least 3 of the following areas:

• Health care payment systems, health insurance industry information systems, and medical services coding and grouping systems
• Using statistical techniques and methodologies involved in setting payment mechanisms of medical professionals, clinics, equipment providers, and hospitals.
• Health care business practices, particularly in billing and payment.
• Administration of workers’ compensation benefits.

AND Five years’ experience related to health policy research and development/implementation of healthcare service delivery across a broad spectrum of services (e.g., primary care, specialty care, ancillary services, health service coordination). Experience in change management, project management, performance management, and program design and evaluation.

A valid, unrestricted driver’s license

Competencies:

Innovative Thinking Oral and written communication Teamwork Meeting and team facilitation Comfortable with ambiguity Willing to learn Quantitative analysis Time and workload management As well as demonstrate and adhere L&I Core Competencies. (For a full list of competencies, please request the PDF from the recruiter listed at the bottom of this announcement.)

Required Equity Competencies: The ability to take action to learn and grow. The ability to take action to meet the needs of others.

Preferred Education, Experience, and Competencies

• A master’s level degree in public administration, health administration, business, public health, or related field
• Knowledge of health care payment systems, health insurance industry information systems, and medical services coding and grouping systems

Things You Need To Know To help you maintain a proper work-life balance, teleworking is one of the work schedule options for this position. L&I also offers flexible custom work schedules. State employees who meet the qualifications will become eligible for a generous retirement package at the end of the employee’s career. Click on the “Benefits” tab to learn more. At L&I, your voice matters. In addition, L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3.3 million workers. Take a look at this brief video and learn more about why L&I is an employer of choice. For this position, telework is permitted part time, The assigned duty station for this position is Tumwater, Washington. For positions where in-office work is necessary, the frequency of telework will be discussed with the supervisor of the position at the time of offer. To receive more information on opportunities at L&I sign up for GovDelivery and select L&I job alerts.

Application process We will contact the top candidates directly to interview for this position. Because we base the selection on information provided by you, it is in your best interest to identify the knowledge, skills, and abilities that address the required and desirable qualifications described in the announcement. Please include the following documents with your application:

• A cover letter describing specific qualifications.
• A current resume detailing applicable experience and education.
• A list of at least three professional references with current telephone numbers.

Please do not attach or place any medical information (vaccination status included) within the application, resume, or cover letter. If you do, we will have to reject your application to safeguard others from receiving your confidential information. You will have to remove the confidential information before you can apply again. To learn more about our hiring process timeline at L&I please visit our L&I recruiting page at Hiring Process at L&I. If you would like to read our website in a language other than English, scroll up to the top of the page to select your language of choice from the banner.

Background Check Notice Prior to a placement in this position, a background check, including criminal history record will be conducted. Information from your background check will not necessarily preclude employment but will be considered in determining your eligibility to perform the requirements of the position.

Other information

• For positions requiring travel, you must have a valid unrestricted driver's license and have insurance if driving a privately owned vehicle on state business.
• Candidates who are offered a job with L&I must possess work authorization that does not require sponsorship by the employer for a visa now or in the future.
• The Department of Labor & Industries complies with the employment eligibility verification requirements of the federal employment eligibility verification form, I-9. The selected candidate must be able to provide proof of identity and eligibility to work in the United States consistent with the requirements of that form on the first day of employment.

Did You Know? In addition to offering a positive balance between life and work, L&I provides one of the most competitive benefits packages in the nation. We also believe your voice matters. We value our employees and their work-life balance by encouraging flexible schedules. L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3 million workers.

Veterans Preference

Applicants wishing to claim Veterans Preference should attach to their application a copy of their DD-214 (Member 4 copy), NGB 22, or signed verification of service letter from the United States Department of Veterans Affairs. Please blackout any personally identifiable data such as Social Security numbers. For further information, contact L&I’s [email protected].

Diversity, Equity, and Inclusion Employer L&I employees come from all walks of life. We strive to hire great people from a wide variety of backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. We believe in the importance of recognizing the value each of us contribute to the success of the agency mission. Having a diverse workforce is this agency’s greatest resource of strength and knowledge. It is through the combination of talents and abilities that we can pursue finding effective measures to provide the best customer service. We are committed to building a diverse and inclusive workplace for everyone and we strongly mean everyone. The State of Washington is an equal opportunity employer. Persons with a disability who need accommodation in the application process or testing process, or those needing this announcement in an alternative format, may call 360-902-5700. TTY users should first call 711 to access the Washington Relay Service. You are welcome to include the name and pronoun you would like to be referred to in your materials and we will honor this as you interact with our award-winning diverse and inclusive organization.

For more Information If you have any questions regarding this job posting, program, or the agency, please contact April Sharp.