Health Actuary Jobs in Washington

Description

Apple Health Eligibility Policy Manager (HCPM/AHSO) – Project

71106480

This is a project position funded through 6/30/2028.

This position will support the implementation of changes being made to Apple Health (Medicaid) coverage for kids ages 0-6. This program manager will convene workgroups and coordinate with interagency stakeholders to analyze policy, create outreach materials, and communicate these changes. If you have professional experience with Medicaid policies, strong communication skills, and are prepared to jump into this evolving landscape, this may be the opportunity for you!

All HCA employees will apply an equity lens to their work, which may include but is not limited to all analyses of core business and processes.

About the division:

The Apple Health Services and Operations (AHSO) division works across HCA and in partnership with the health care community at local, state and federal levels to develop and manage high quality and evidence-based health care programs and purchase services that enhance Washington State residents’ ability to access appropriate, quality health care.

Within AHSO, the Eligibility Policy Innovation and Community Support (EPICS) section consists of staff who advise external stakeholders in community-based health organizations on behalf of the agency and evaluate and analyze federal statutes and regulations. EPICS staff formulate state policy for Apple Health eligibility and participate in long range strategic planning for Apple Health eligibility policy and service delivery while being responsive to short-term objectives that have significant impact for almost 2 million residents of the state of Washington who are eligible for Apple Health and who need these programs in order to receive affordable medical services.

About the position:

This position works as a technical expert in the maintenance, development, and implementation of eligibility policy changes from the state and federal levels. This position helps to support the ongoing success of the Apple Health program in Washington State. This position is a project position that will help support the ongoing implementation and maintenance continuous eligibility for kids 0-6 through this 1115 waiver demonstration approval period and lead the waiver project to remove these waiver provisions within Apple Health programs after 2028.

This position is eligible to telework and is typically not required to report on-site. The default assigned work location of all Health Care Authority (HCA) positions – both on-site and telework eligible positions – is within the State of Washington. This position reports to Olympia, WA. Frequency of onsite work will vary based on business and operational needs. All agency employees are required to report on-site in Olympia on their first and last days of employment to pick up and return state-issued equipment, regardless of telework status or location.

Duties

Some of what you will do:

• Coordinate, analyze and maintain current eligibility policy deliverables for the continuous eligibility for kids aged 0-6, 1115 waiver demonstration project.
• Lead the efforts to remove this waiver provision post waiver approval in 2028.
• Collaborate with business partners to develop eligibility processes ensuring compliance with federal and state policy.
• Develop and assist in executing an outreach and education campaign to educate customers and community on upcoming changes.
• Coordinate monthly CMS meetings.
• Develop and provide clarification and policy expertise regarding Apple Health eligibility state and federal policy and procedures.
• Lead and manage stakeholder relations to implement necessary changes. Stakeholders can include the public, community assisters, financial councils, providers, legal advocates, tribal partners, agency and internal partners, and other interested parties.
• Translate Federal policy and guidance to formulate statewide Apple Health policy.
• Analyze agency policy and operations, make decisions on improvements, and work with agency staff to implement.
• Develop proposals for review by executive management on Apple Health policy, practice, and implementation.
• Train local stakeholders and staff to ensure communities understand Apple Health as it relates to implemented strategies for enrollment policies and procedures.
• Monitor enrollment strategies that are being carried out by HCA staff and community-based organizations (CBO).

Qualifications

Required qualifications:

Qualifying candidates will meet one of the following criteria options:

Option 1:

• Master’s degree with a major study in health, social science, public administration, or closely related field and
• Three (3) years of experience supervising or providing consultative experience in health services, social services, or Medicaid programs.

Option 2:

• Bachelor’s degree with a major study in health, social science, public administration, or closely related field and
• Five (5) years of experience supervising or providing consultative experience in health services, social services, or Medicaid programs.

Option 3:

• Associate degree with a major study in health, social science, public administration, or closely related field and
• Seven (7) years of experience supervising or providing consultative experience in health services, social services, or Medicaid programs.

Option 4:

• Nine (9) years of experience supervising or providing consultative experience in health services, social services, or Medicaid programs.

Option 5:

• One year as a Health Care Program Specialist in state government performing duties and responsibilities in the areas listed above.

Required competencies:

• The ability to take action to learn and grow.
• The ability to take action to meet the needs of others.
• Knowledgeable in all statewide Apple Health eligibility policy.

Preferred qualifications:

• Two years working knowledge of state and federal laws, regulations, and procedures as they relate to Medicaid, healthcare reform, and delivery of medical programs.
• Professional experience communicating with internal and external stakeholders including presentations and writing reports.
• Two years of experience in conducting analyses of Medicaid system, facts, statistics, and other relevant materials to resolve the questions or problems concerning Medicaid and state medical programs eligibility policy, legislative changes, and budgetary constraints.
• Two years of experience in drafting Medicaid policy and procedures; researching Medicaid policy in other states, developing scenarios or strategies for long and short-term division planning, and reviewing implementation of programs for compliance with legal requirements.
• Working knowledge of Washington State governmental structure and function of division, especially Apple Health (Medicaid) policies, procedures, and services to ensure appropriate Medicaid services to participants of the division’s programs.
• Knowledge and applied skills in the principles of management and organizational practice. This includes group process and problem-solving methodologies, conflict management, and negotiation skills.
• Effective oral and written communications with clients, business community, and other professional/managerial groups including top agency management, public speaking; independent decision making; strong interpersonal skills; planning and project management; leadership.
• Applied knowledge and experience in computer skills, including knowledge and experience in ACES, Barcode, ProviderOne, Washington Healthplanfinder, and other related client data sources. Considerable experience with software programs including work processing, spreadsheets, databases, and flow charts.
• Two years of experience in educating communities regarding federal Medicaid and state-funded medical program eligibility policy, and program offerings; and developing and presenting Medicaid and state medical program eligibility policy to stakeholders, legislators, and community leaders in a precise, understandable manner.

How to apply:

Only candidates who reflect the minimum qualifications on their NEOGOV profile will be considered. Failure to follow the application instructions below may lead to disqualification. To apply for this position, you will need to complete your profile which includes three professional references and attach in separate files:

• A cover letter that specifically addresses how you meet the qualifications for this position
• Current resume

To take advantage of veteran preference, please do the following:

• Attach a copy of your DD214 (Member 4 long-form copy), NGB 22, or USDVA signed verification of service letter.
• Please black out any PII (personally identifiable information) data such as social security numbers. Include your name as it appears on your application in careers.wa.gov.

Supplemental Information

About HCA:

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

What we have to offer:

• Meaningful work with friendly co-workers who care about those we serve Voices of HCA
• A clear agency mission that drives our work and is person-centered HCA's Mission, Vision & Values
• A healthy work/life balance, including alternative/flexible schedules and mobile work options.
• A great total compensation and benefit package WA State Government Benefits
• A safe, pleasant workplace in a convenient location with restaurants, and shopping nearby.
• And free parking!

Notes:

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.

HCA is an equal opportunity employer. We value the importance of creating an environment in which all employees can feel respected, included, and empowered to bring unique ideas to the agency. HCA has five employee resource groups (ERGs). ERGs are voluntary, employee-led groups whose aim is to foster a diverse, inclusive workplace aligned with HCA’s mission. Our diversity and inclusion efforts include embracing different cultures, backgrounds and viewpoints while fostering growth and advancement in the workplace. Studies have shown women, racial and ethnic minorities, and persons of disability are less likely to apply for jobs unless they feel they meet every qualification as described in a job description. Persons over 40 years of age, disabled and Vietnam era veterans, as well as people of all sexual orientations and gender identities are also encouraged to apply. If you have any questions about the required qualifications or how your experience relates to them, please contact us at HCAjobs@hca.wa.gov. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Jake Nelko at 360-725-0945 or jake.nelko@hca.wa.gov.

The Washington State Health Care Authority (HCA) is an E-Verify employer. All applicants with a legal right to work in the United States are encouraged to apply.

E-Verify® is a registered trademark of the U.S. Department of Homeland Security.

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More than Just a Paycheck!

Employee benefits are not just about the kind of services you get, they are also about how much you may have to pay out of pocket. Washington State offers one of the most competitive benefits packages in the nation.

We understand that your life revolves around more than just your career. Like everyone, your first priority is ensuring that you and your family will maintain health and financial security. That's why choice is a key component of our benefits package. We have a selection of health and retirement plans, paid leave, staff training and other compensation benefits that you can mix and match to meet your current and future needs.

Read about our benefits:

The following information describes typical benefits available for full-time employees who are expected to work more than six months. Actual benefits may vary by appointment type or be prorated for other than full-time work (e.g. part-time); view the job posting for benefits details for job types other than full-time.

Note: If the position offers benefits which differ from the following, the job posting should include the specific benefits.

Insurance Benefits

Employees and their families are covered by medical (including vision), dental and basic life insurance. There are multiple medical plans with affordable monthly premiums that offer coverage throughout the state.

Staff are eligible to enroll each year in a medical flexible spending account which enables them to use tax-deferred dollars toward their health care expenses. Employees are also covered by basic life and long-term disability insurance, with the option to purchase additional coverage amounts.

To view premium rates, coverage choice in your area and how to enroll, please visit the Public Employees Benefits Board (PEBB) website. The Washington Wellness program from the Health Care Authority works with PEBB to support our workplace wellness programs.

Dependent care assistance allows the employee to save pre-tax dollars for a child or elder care expenses.

Other insurance coverage for auto, boat, home, and renter insurance is available through payroll deduction.

The Washington State Employee Assistance Program promotes the health and well-being of employees.

Retirement and Deferred Compensation

State Employees are members of the Washington Public Employees' Retirement System (PERS). New employees have the option of two employer contributed retirement programs. For additional information, check out the Department of Retirement Systems' web site.

Employees also have the ability to participate in the Deferred Compensation Program (DCP). This is a supplemental retirement savings program (similar to an IRA) that allows you control over the amount of pre-tax salary dollars you defer as well as the flexibility to choose between multiple investment options.

Social Security

All state employees are covered by the federal Social Security and Medicare systems. The state and the employee pay an equal amount into the system.

Public Service Loan Forgiveness

If you are employed by a government or not-for-profit organization, and meet the qualifying criteria, you may be eligible to receive student loan forgiveness under the Public Service Loan Forgiveness Program.

Holidays

Full-time and part-time employees are entitled to paid holidays and one paid personal holiday per calendar year.

Note: Employees who are members of certain Unions may be entitled to additional personal leave day(s), please refer to position specific Collective Bargaining Agreements for more information.

Full-time employees who work full monthly schedules qualify for holiday compensation if they are employed before the holiday and are in pay status for at least 80 nonovertime hours during the month of the holiday; or for the entire work shift preceding the holiday.

Part-time employees who are in pay status during the month of the holiday qualify for the holiday on a pro-rata basis. Compensation for holidays (including personal holiday) will be proportionate to the number of hours in pay status in the month to that required for full-time employment, excluding all holiday hours. Pay status includes hours worked and time on paid leave.

Sick Leave

Full-time employees earn eight hours of sick leave per month. Overtime eligible employees who are in pay status for less than 80 hours per month, earn a monthly proportionate to the number of hours in pay status, in the month to that required for full-time employment. Overtime exempt employees who are in pay status for less than 80 hours per month do not earn a monthly accrual of sick leave.

Sick leave accruals for part-time employees will be proportionate to the number of hours in pay status, in the month to that required for full-time employment. Pay status includes hours worked, time on paid leave and paid holiday.

Vacation (Annual Leave)

Full-time employees accrue vacation leave at the rates specified in WAC 357-31-165(1) or the applicable collective bargaining agreement (CBA). Full-time employees who are in pay status for less than 80 nonovertime hours in a month do not earn a monthly accrual of vacation leave.

Part-time employees accrue vacation leave hours in accordance with WAC 357-31-165(1) or the applicable collective bargaining agreement (CBA) on a pro rata basis. Vacation leave accrual will be proportionate to the number of hours in pay status, in the month to that required for full-time employment.

Pay status includes hours worked, time on paid leave and paid holiday.

As provided in WAC 357-58-175, an employer may authorize a lump-sum accrual of vacation leave or accelerate the vacation leave accrual rate to support the recruitment and/or retention of a candidate or employee for a Washington Management Service position. Vacation leave accrual rates may only be accelerated using the rates established WAC 357-31-165.

Note: Most agencies follow the civil service rules covering leave and holidays for exempt employees even though there is no requirement for them to do so. However, agencies are required to adhere to the applicable RCWs pertaining holidays and leave.

Military Leave

Washington State supports members of the armed forces with 21 days paid military leave per year.

Bereavement Leave

Most employees whose family member or household member dies, or for loss of pregnancy, are entitled to five (5) days of paid bereavement leave. In addition, the employer may approve other available leave types for the purpose of bereavement leave.

Additional Leave

Leave Sharing

Parental Leave

Family and Medical Leave Act (FMLA)

Leave Without Pay

Please visit the State HR Website for more detailed information regarding benefits.

Updated 01-07-2026