Care Coordination Quality Assurance Administrator (Operations & Policy Analyst 3)

$68,964 - $105,972/Yr

Oregon.gov

Full-time - Mid Level

About the position

The Care Coordination Quality Assurance Administrator (Operations & Policy Analyst 3) at the Oregon Health Authority is responsible for overseeing the development and implementation of quality assurance mechanisms for Medicaid Fee-for-Service (FFS) care coordination contracts. This role focuses on establishing statewide standards for contract administration, ensuring effective care coordination, and improving health outcomes for Medicaid members. The position involves collaboration with various stakeholders, data analysis for compliance monitoring, and the promotion of health equity within the healthcare system.

Responsibilities

• Oversee the development of FFS care coordination contract administration policy and quality improvement processes.
• Research current federal trends and statewide Coordinated Care Organization (CCO) practices.
• Develop Oregon Administrative Rules (OARs) for FFS care coordination.
• Create criteria for measuring the effectiveness of FFS contract administration.
• Facilitate data collection and analysis to monitor FFS program compliance.
• Collaborate with behavioral, oral, and physical health providers, and other stakeholders.
• Provide data analysis for reporting requirements set by the Centers for Medicare and Medicaid Services (CMS).
• Ensure contract accountability and metrics for provider network adequacy.

Requirements

• Seven years of experience in professional-level evaluative, analytical, and planning work.
• A degree in Business or Public Administration, Behavioral or Social Sciences, or a related field can substitute for some experience.

Nice-to-haves

• Ability to read, write, speak, and interpret English and one of the five most common languages in Oregon (Spanish, Vietnamese, Chinese, Russian, Korean).
• Experience in advancing health equity and delivering culturally responsive services.
• Knowledge of Oregon Administrative Rules and Oregon Revised Statutes.
• Experience with Medicaid administration in Oregon and working with Community Mental Health Programs.

Benefits

• Exceptional medical, vision, and dental benefits with low out-of-pocket costs.
• 11 paid holidays each year.
• 3 additional paid 'Personal Business Days' each year.
• 8 hours of paid sick leave accumulated every month.
• Progressive vacation leave accrual with increases every 5 years.
• Pension and retirement programs.
• Optional benefits include short-term and long-term disability, deferred compensation savings program, and flexible spending accounts.