Policy, Rules & Compliance Section Manager (WMS/ERB)
Description
Policy, Rules & Compliance Section Manager
This is a full-time permanent, hybrid position. Employees will be asked to attend in-person meetings or events based on business needs.
All HCA employees are required to be Washington state residents upon their first day of employment.
The Opportunity
The main purpose of this position is to provide leadership, direction, and oversight necessary to seven FTEs to ensure the PEBB and SEBB Programs comply with state and federal regulation that governs employee benefit plans; formulate administrative policy. This position advises the PEB and SEB Boards in the development of eligibility and enrollment policy. It also oversees and directs the work necessary to promulgate WAC (rules) for the PEBB and SEBB Programs. This position directs the work related to the development of agency request legislation and budget decision packages for the ERB Division; overseeing the analysis of federal and state legislation.
Key Responsibilities
- Oversee and ensure that PEBB and SEBB Program WAC is promulgated in accordance with HCA policy and state law, including the Administrative Procedures Act (APA) (chapter 34.05 RCW); the Code Reviser regulations in chapters 1-21 WAC; and applicable Executive Orders.
- Develop, present, and recommend eligibility and enrollment policy resolutions to the PEB and SEB Boards to support the administration of PEBB and SEBB benefits.
- Oversee the development and implementation of rules and policy needed to support the on-going alignment of school employee benefits and improve the administration of retiree insurance coverage.
- Oversee the PEBB and SEBB rule revision process and annual assessment of rule effectiveness.
- Plan, organize, oversee, and control the work performed by ERB Division legislative analysts during session to receive, disseminate, and analyze legislative proposals and to respond to legislative inquiries.
- Oversee, plan, lead, organize, and control the work to analyze federal regulations that impact the administration of eligibility and enrollment of the PEBB Program benefits offered to state employees, retirees, and their families and to SEBB Program benefits offered to school district employees and their families.
- Review all PEBB and SEBB Communications to ensure that issued guidance are aligned to state and federal laws, WAC, PEBB and SEBB Program Administrative Policy, and legislative mandates or initiatives.
- Project management and implementation oversight for complex projects including but not limited to, lawsuits, federal or state legislation requiring PEBB and SEBB program changes, Evaluation, and system replacement efforts, including strategic direction related to processes, funding, risk, and communications as they apply to eligibility and rules implementation.
Why You’ll Love This Role
As a vital leader within the Health Care Authority (HCA) and a voting member of the Agency Policy and Procedure Committee, you will guide a dedicated team of seven FTEs to shape administrative policy and rulemaking that directly controls $6 billion in benefit expenditures. Your decisions will protect and enhance the health, vision, dental, and life insurance benefits of nearly 885,000 public and school employees, retirees, and their families.
What You Bring
If you are driven by the opportunity to provide influence over state legislation, counsel executive boards, and integrate an equity lens into enterprise-wide healthcare purchasing strategies, this position elevates you into meaningful public service.
Required Qualifications
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.
- This position requires advanced knowledge of health benefits delivery systems, the highly technical and dynamic nature of health care and payroll/benefit functions, and the fiscal and political environment of a publicly sponsored employee benefits program operating in a predominately private sector health care market.
Advanced Technical and Professional Knowledge:
- General knowledge of Affordable Care Act provisions.
- Working knowledge of laws and regulations governing benefits plans.
- Working knowledge of best practices in employee benefits administration.
- Working knowledge of the full scope of health plan administration and how the elements are coordinated into a comprehensive functional system.
Complex Project Design, Planning, and Management:
- Demonstrated ability to lead diverse work groups that deal with complex aspects of employee benefit sponsorship and health plan administration, including work groups that are composed of members with varied professional credentials, education, and experience.
- Demonstrated ability to design, implement, and manage the operations of large complex projects in an environment involving special interest stakeholders, legislators of both houses and political parties, public and private contractor, community collaboratives, and inter-governmental partnerships.
Communication and Interaction with Stakeholders:
- Group facilitation skills necessary to lead productive and efficient discussions.
- Communication skills necessary to effectively share knowledge with diverse audiences including co-workers, contractors, health care providers, public officials, enrollees, and special interest stakeholders to foster informed decision-making.
Leadership and Decision making:
- Demonstrated ability to work effectively within the public arena through effective stakeholder interactions, inter-agency teamwork, and sensitivity to public attitudes and concerns.
- Decision-making skills are necessary to make thoughtful responsive decisions that include assessing potential risks and managing them and employing a methodology that revisits and adjusts decisions as new information comes available.
- Demonstrated ability to function in an environment that requires concurrent management of multiple complex activities, flexible work hours, tight timelines, frequent periods of high stress, and resource limitations associated with being a public sector program financed with tax dollars.
Advanced Organizational Management:
- Demonstrated ability to establish a realistic organizational vision, articulate clear measurable goals, define meaningful action plans, and maintain a systems view that ties all the individual activities together.
- General knowledge of fiscal management and budgeting.
Human Resources Leadership and Management:- Demonstrated ability to form and lead a cohesive, constructive team working relationship in an environment where participants represented a variety of health care professionals, including MDs, RNs, LPNs, PharmDs, where no clear authority hierarchy exists.
- Leadership skills are necessary to guide and inform others in a manner that enables them to reach successful completion while retaining ownership of their assigned responsibilities.
- Mentoring skills are necessary to develop a broad base of institutional knowledge and opportunities for internal career advancement.
Required Competencies
- Equity lens – All HCA employees are required to consider equity in their decisions, processes, and day-to-day work, including how their work may affect the people and communities we serve.
- The ability to take action to learn and grow – You take action to learn and grow by seeking new perspectives, learning from experiences, and using what you’ve learned to continuously improve how you work and serve others.
- The ability to take action to meet the needs of others – You take action to meet the needs of others by listening, understanding different perspectives, and responding with care, respect, and solutions that support the people of the communities we serve.
Preferred Qualifications
While these are not required, having them may help you stand out as an applicant.
- Master’s degree in health care discipline, public health, public administration, business administration, or other health care field directly related to the work of administering employee benefits.
OR
- Bachelor’s degree in a health care discipline, public health, public administration, business administration, or other health care field directly related to the work of administering employee benefits.
OR
- Four (4) or more years of experience in management position(s) or rule, technical, or manual writing may substitute, year-for-year, for required education.
- Specialized knowledge of health care systems, clinical systems, customer service metrics, and some knowledge of the tax and legal consequences associated with ERISA, the Public Health Services Act, HIPAA, Cafeteria plans, WA State Title 28A, 41 and 48, as it relates to both employer-based benefits and brokering benefits to other employers.
About the Employees and Retirees Benefits (ERB) Division
The Employees and Retirees Benefits (ERB) Division oversees three lines of work with an overall annual spending of ~$6 billion dollars for almost 885,000 covered lives: The Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and for the state’s individual insurance market, ERB oversees the contracting and management of the state’s “public option” plan offerings (called Cascade Select).
About the Washington State Health Care Authority
Better Health. Better Care. A Healthier Washington.
At HCA, we work to ensure people across Washington have the opportunity to be as healthy as possible. As the State’s largest health care purchaser and behavioral health authority, HCA serves nearly 3 million Washington residents through Apple Health (Medicaid), Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs, and behavioral health services. Through this work, HCA purchases and coordinates care coverage, supports behavioral health prevention, treatment, crisis response, and recovery and helps strengthen access to high-quality care across Washington.
More than a benefits package:
We want our employees to have the support, flexibility, and benefits they need to do their best work and build a career that works for their life. As a Washington State HCA employee, you’ll have access to a comprehensive benefits package that supports your health, financial well-being, and work-life balance. Our benefits are designed to support you today while helping you plan for the future. Learn more about why HCA by visiting the Voices of HCA and the "Who we are" section of our website.
Your total compensation is more than your paycheck:
- Remote work and flexible schedules
- Medical, dental, vision, and basic life insurance
- Paid vacation, sick leave, and 12 paid holidays
- Paid Family and Medical Leave (PFML)
- Retirement options to plan for the future
- Training and professional development opportunities
- Employee wellness programs
- Learn more about Washington State Employee Benefits
Work Location and Schedule
This is a full-time 40-hour-per-week hybrid position. You will report to the HCA office located in Olympia, WA for in-person work. Our standard business hours are Monday through Friday, 8 a.m. to 5 p.m., with alternative work schedules considered based on business needs. When working in-person, you will work in a shared space, open office environment. In this role you’ll regularly collaborate with colleagues, agency leaders, state and federal partners, and other external partners or customers. Occasional travel may be required for meetings, training, or other business needs. All employees are required to report to our Olympia office on their first and final day of employment.
Supplemental Information
Our commitment to an inclusive workplace:
The Health Care Authority is an equal opportunity employer. We are committed to creating a workplace where employees are respected, included, and supported in bringing their experiences, perspectives, and ideas to work.
Our commitment to inclusion is reflected in how we work together and serve the people of Washington. HCA also supports five voluntary employee led Employee Resource Groups (ERGs), which create opportunities for connection, community, learning, and professional growth.
Application Directions
To be considered, you must complete the online application in full and submit all required materials. Incomplete applications or applications missing required materials will not be considered. When completing your application, please include the following required materials:
- Cover letter: describing your qualifications for this specific position
- Resume: that details your applicable experience and education.
- Three (3) professional references: References must be entered directly into the designated references section of your application. We require 3 professional references including at least one current or recent supervisor.
We encourage you to apply! If you meet the required qualifications for this position; we want to hear from you. Desired qualifications describe additional experience, knowledge or skills that may be helpful in the role, but they are not required to be considered for the position. We welcome applicants with different backgrounds, experiences, identities, and perspectives.
Veterans
We value the experience and skill veterans bring to the workforce and encourage veterans, transitioning service members, and military spouses to apply. Eligible veterans may qualify for veterans’ preference in accordance with Washington State Law. If you are claiming veterans’ preference, you must attach your applicable DD-214 documentation to your application. Please redact your social security number, date of birth, and any other sensitive information before uploading and attaching the document.
Need accommodations or have questions? If you have questions, need assistance with the application process, require an accommodation, or would like to request this posting in an alternative format, please contact Angelic Matthews, human resources consultant – recruiter, at HCAjobs@hca.wa.gov and reference the recruitment title and job number in the subject line.
Technical Support: Reach out to NEOGOV directly at 1-855-524-5627 for technical support and login issues.
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.
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