Health Insurance Operations Manager jobs in Washington

This recruitment will remain open until the position is filled. The agency reserves the right to make a hiring decision at any time after the initial screening date on October 5, 2023. It is in the applicant’s best interest to submit materials as soon as possible.

OIC CAREER OPPORTUNITY

The Office of the Insurance Commissioner’s (OIC) Provider Network Oversight Program is seeking a motivated and qualified individual to fill a Health Care Benefit Manager Forms Analyst (Functional Program Analyst 3) position in the Health Care Benefit Manager (HCBM) unit. This position is assigned to the Rates, Forms and Provider Networks Division, located in our Tumwater office.

HCBM’s act as intermediaries between health carriers, health care providers, and patients affecting health care services delivered by providers and the health care choices of patients. This professional level position independently performs analytical reviews and evaluations of these intermediary contracts related to provider network management, leasing arrangements, and provider contracts between health carriers and health care benefit managers.

If you're interested in a dynamic career that protects consumers' interests and promotes a healthy business environment in this state, please apply and become part of our dynamic team.

This recruitment may be used to establish a qualified pool of candidates for Functional Program Analyst 3 vacancies in the next sixty days.

This is a Washington General Service position. The monthly salary range for this position is $4,842 – $6,510.

AGENCY PROFILE AND VALUES

The Office of the Insurance Commissioner (OIC) operates under the direction of the state's Insurance Commissioner, a statewide elected official. Our mission is to provide consumer protection and regulation of the state's insurance industry.

With a workforce of approximately 265 employees, we are one of the smaller state agencies in Washington state government and are fortunate to have a stable funding source that does not rely on the state's general fund.

Because we are a small agency, you will truly get a chance to understand the 'big picture' of what we do and why we do it. You will also have a chance to get to know your co-workers.

We value diversity in the workplace. We challenge our employees to continuously improve the way we do business and to meet and exceed the needs of our customers.

To learn more about this agency, we invite you to visit our website at http://www.insurance.wa.gov/ and listen to our employees talk about why they love working here.

BENEFITS OF WORKING FOR OIC

Washington State offers one of the most competitive benefits packages in the nation. We offer a great selection of health, dental and retirement plans, life insurance, long-term disability, flexible spending account, paid leave, 11 paid holidays, and compensation benefits for you and your family. You can find more information about benefits at Benefits - careers.wa.gov.

Additional benefits that may be available include:

• 
  Wellness programs.
• Dependent care assistance.
• Washington State Employee Assistance Program.
• Federal Social Security and Medicare systems.
• Additional Leave; Leave Sharing, Parental Leave, Family and Medical Leave Act (FMLA), Leave Without Pay.
• Deferred Compensation (supplemental retirement plan).
• Training and development opportunities, including tuition reimbursement (Tuition Reimbursement is available for eligible employees subject to guidelines and funding.)
• Program for Public Service Loan Forgiveness (if applicable)
• Free parking at our main office in Tumwater.
• A stable funding source that does not rely on the state's general fund.
• The fulfillment of public service.
• Excellent work-life balance.
• Flexible work schedules and telework opportunities.
• Commitment to diversity in the workplace and support one another with respect and trust.
• Free Thurston County Transit public transportation.

These duties include but are not limited to:

• Analyze and evaluate Health Carrier and HBCM contracts.
• Communicates issues about compliance concerns with contract provision with insurance companies, health care benefit managers, and or their third-party filers.
• Establishes what is necessary for the contract to be considered compliant with state law, federal law, and case law.
• Conducts research to provide information and subject matter guidance to various entities.
• Facilitates resolution with contracting issues or non-compliance.
• Consults and discusses contract form provisions, regulations, and case law with OIC staff to ensure consistent and uniform review standards of health care benefit management forms.

Required Qualifications:

• Bachelor’s degree Public Administration, Business Administration, Social Sciences, or closely related field. Degree must be obtained from an accredited college or university whose accreditation is recognized by the U.S. Department of Education and the Council for Higher Education Accreditation (CHEA), or foreign equivalent.

• Professional private or public sector work in analyzing and applying RCWs, WACs, federal regulations, or case law in the administration of insurance policies or insurance activities, or
• Professional private or public sector work on one or more lines of insurance, or
• Professional private work on one or more of the various healthcare third-party services for a health plan, or
• Reviewing legal documents and forms, including contracts.

• Intermediate-level skills and experience in Microsoft Outlook and Word.
• Demonstrated experience organizing work, establishing timelines, and meeting deadlines.

How to Apply: Applications for this recruitment will be accepted electronically. Please select the large green "apply" button at the top of this announcement. If you have not done so previously, you will need to set up an account profile.

Please provide three (3) professional references on your application. A professional reference is defined as an individual who has been paid to supervise your work and can attest to your work performance, technical skills, and job competencies. If you do not have any or sufficient professional references, please include non-related professionals, such as educators or other professional associates.

The initial screening will be based on the content and completeness of your application and the materials submitted. All information may be verified, and documentation may be required. Your letter of interest should describe how your experience, training and education make you a viable and competitive candidate for this position. Applications with comments such as "see attachments" or "see resume" in the supplemental question responses will be considered incomplete.

General suggestions for creating a good application:

• Read the job posting very carefully. Find out as much as you can about the position.
• Make sure you are very diligent in following all the application instructions. Include all requested documentation.
• Make sure your application and supplemental question responses address how you meet each of the required and desired qualifications.
• Carefully read each of the supplemental questions and respond completely to each one. Pay attention to each component of the question, providing examples, and thoroughly describing when and where you achieved the experience. Detail the types of work you performed, the work products, etc., to demonstrate 'how'.
• Specifically include all of your work experiences doing the same or similar work, especially if you reference work in these jobs in describing when/where you gained experience or skills.
• Make sure your application reflects your best writing.

• This position is represented by the Washington Federation of State Employees (WFSE).
• State law (RCW 48.02.090[5]) prohibits employees of the OIC from having any interest, directly or indirectly, in an insurance company other than as a policyholder. This prohibition includes the receipt of renewal commissions. If employment is accepted with this agency, you agree to abide by this state law.
• If a degree or other credentials are listed by the candidate, proof will be required at the finalist stage. Candidates are encouraged to pre-plan for this. University degrees must be recognized by the U.S. Department of Education and the Council for Higher Education Accreditation (CHEA) or foreign equivalent.
• If a degree was awarded outside the United States, candidates must provide a credential evaluation report.
• 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 but will be considered in determining the applicant’s suitability and competence to perform in the position.
• If claiming veteran status, please send your DD 214 to recruitment@oic.wa.gov with HCBM 2023-12331 in the subject line. Please do not attach the DD 214 to your application materials. Please black out personally identifiable data such as social security numbers.
• The Office of Insurance Commissioner is an equal opportunity employer. Auxiliary aides and services are available upon request to individuals with disabilities. Please contact the recruiter listed above.
• If you are having technical difficulties creating, accessing (log in, password or email issues) or completing your application (error messages), please call toll-free at (855) 524-5627.
• For general questions regarding applying for jobs, contact the recruiter or careershelp@des.wa.gov.