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HCBM Contract Analyst (FPA 3)

Office of Insurance Commissioner for WA State
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This recruitment will remain open until September 28, 2024. The agency reserves the right to make a hiring decision at any time after the initial screening date on September 12, 2024. 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) Health Care Benefit Manager (HBCM) Unit is seeking a motivated and qualified individual to fill a HCBM Contract Analyst (Functional Program Analyst 3) position.  This position is assigned to the Rates, Forms, and Providers Network Division, located in our Tumwater office.
 
This professional-level position independently performs analytical reviews and evaluations of forms related to health care benefit management contracts and will identify compliance matters with potential recommendations for correction of contract language, thereby assisting health care benefits managers and health carriers meet legal compliance.
 
What are we looking for?
 
We are looking for a candidate who is interested in learning about the contract relationships between insurance companies and intermediaries who perform health care benefit management services such as pharmacy benefit management, prior authorization review, and disease management.  A successful candidate will enjoy collaborating in a team environment yet be comfortable working independently, be proficient in the specific skills required for the role, able to handle change and adjust to new challenges, competent in identifying issues and devising effective solutions, proactive in taking on tasks and going beyond the minimum requirements, demonstrates reliability, responsibility, and a strong commitment to their work, able to maintain positive working relationships and has effective communication skills, and able to prioritize tasks and meet deadlines effectively.
 
What’s in it for you?
 
The HCBM is a new unit. The successful candidate would get to be a part of building the team from the ground up and influence its culture. HCBM regulation is new at both the state and federal level and the success candidate will join in this exciting work of regulating entities that directly make decisions about an enrollee’s access to health care and prescription medications.

 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 $4,987 - $6,705.
 
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 and retirement plans, paid leave, and compensation benefits for you and your family.
 
Additional Benefits:
 

 

Duties

The duties of the position include, but are not limited to: 
 

  • Analyzing and evaluating HCBM contracts using the appropriate checklists, applicable chapters of the RCWs, WACs, and case law.
  • Reporting, consulting, and collaborating with the Functional Program Analyst 4 – Supervisor and Program Manager about issues that restrict a company from issuing compliant contracts in the marketplace or that may impact the marketplace broadly.
  • Communicating issues about compliance concerns with contract provisions and HCBMs and/or their third-party filers.
  • Establishing what is necessary for the contracts to be considered compliant.
  • Conducting research to provide subject matter guidance and information to the appropriate parties.
  • Facilitating resolution with contracting issues or non-compliance.
  • Consulting and discussing 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: 
 
Six (6) years of experience working in contract writing, management, or regulation through a combination of any of the following:
 

  • Degree completion (associate degree = 2 years’ experience, bachelor’s degree = 4 years’ experience, and so on); and/or
  • Ensuring compliance with governmental statutory and regulatory requirements; and/or
  • Professional private or public sector work on one or more lines of insurance; and/or
  • Professional private work on one or more of the various healthcare third party services for a health plan; and/or
  • Reviewing legal documents and forms, including contracts.

*The 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.
 
AND
 

  • Intermediate level Microsoft Office Outlook, Word, and Excel skills.


Preferred/Desired:
 

  • Experience using the System for Electronic Rate and Form Filing (SERFF) software program.