Medical Assistance Specialist ; Lead Internal

This is a full-time, permanent, remote position. Employees may occasionally be asked to attend an in-person meeting or event based on business needs.

All HCA employees are required to be Washington state residents upon their first day of employment.

Lead a team that connects Washington residents to the health coverage they need. The Medical Eligibility Determination Services (MEDS) office in HCA's Apple Health Eligibility and Access (AHEA) Division is seeking a Medical Assistance Specialist 4 to serve as the lead worker for a team of eight or more Medical Assistance Specialists. As the team's eligibility expert, you will guide staff through complex Apple Health (Medicaid) and Children's Health Insurance Program (CHIP) cases, develop and deliver training, and step in for the supervisor when needed to keep day-to-day operations running smoothly.

• Serve as lead worker for a team of eight or more Medical Assistance Specialists, monitoring team workload and priorities.
• Act on behalf of the supervisor in their absence and support the team's day-to-day operations.
• Provide eligibility support and clarification to staff, interpret policy and regulations, and help determine the final disposition of complex eligibility cases.
• Apply complex federal and state eligibility rules (WAC and RCW) to household circumstances to make accurate initial and ongoing eligibility decisions.
• Develop and deliver eligibility, systems, interviewing, and workload management training for new and experienced staff, including training on program changes and identified performance gaps.
• Conduct internal program audits to identify error trends and performance issues.
• Analyze workflow and system problems, and devise and implement new or revised procedures.
• Use multiple interconnected systems, including the Automated Client Eligibility System (ACES), Provider One, and the Document Management System (DMS).
• Research, prepare, and represent agency in administrative hearings, and partner with advocates, providers, and Community Services Offices to resolve issues.

• You’ll help ensure individuals and families across Washington get accurate, timely access to health coverage.
• You’ll build your leadership experience by coaching, training, and guiding a team of eligibility specialists.
• You’ll be the go-to expert your team relies on, with your knowledge shaping how the work gets done.
• You’ll lead your team primarily remotely, with occasional opportunities to connect in person.

You are a patient teacher and a steady leader who enjoys helping others grow. You stay calm when cases get complicated, take a thoughtful approach to problem-solving, and hold yourself to a high standard of accuracy. You communicate clearly with staff, managers, and customers, maintain confidentiality, and support your team and management with professionalism. You are always looking for ways to improve how the work gets done.

Experience may have been gained through paid or unpaid activities. Please ensure any relevant experience defined below is outlined in your cover letter, resume, and application.

• Demonstrated ability to apply advanced knowledge of federal and state laws, regulations, policies, procedures, and program requirements to complex medical assistance program issues and circumstances.
• Demonstrated skill to analyze complex, unusual, or escalated program issues, evaluate relevant information and requirements, and develop accurate and well-supported determinations, recommendations, or solutions.
• Demonstrated knowledge to provide technical leadership,…