PPM IV - BHRD Business Operations Manager

King County   Seattle, WA   Full-time     Business Development
Posted on October 6, 2021
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The Department of Community and Human Services values diverse perspectives and life experiences. The Department encourages people of all backgrounds to apply, including Black, Indigenous, and People of Color, immigrants, refugees, women, LGBTQ, people with disabilities, veterans, and those with lived experiences.  

King County's Department of Community and Human Services (DCHS) provides equitable opportunities for people to be healthy, happy, and connected to community.

The Business Operations Manager will oversee the implementation, design and integration of traditional managed care operational functions under both the Integrated Managed Care (IMC) and the BH-Administrative Services Organization (BH-ASO) contracts within the Behavioral Health and Recovery Division (BHRD).

The Business Operations Manager will bring together program leads from various functional areas to support implementation, design and integration of traditional managed care operations including, but are not limited to the following: oversight of encounter collection, validation, and submission to administrative entities; provider payments and reconciliation; provider relations, training, capacity building and network management; eligibility and membership; identifying and clarifying business rules and technical specifications to support system configuration and IT, and data collection, and reporting to administrative and regulatory agencies.

The incumbent in this position will align all work with the mission of the Department's Equity and Social Justice strategic plan (i.e., to reinforce and embed equity and social justice principles into policies, practices, attitudes and actions that produce equitable access, opportunities, treatment, impacts and outcomes for all).

WHO MAY APPLY: This position is open to all qualified candidates that meet the minimum qualifications. 

REQUIRED MATERIALS: Candidates who wish to be considered for this position must submit an online King County application and respond to the supplemental questions. Your application may be rejected as incomplete if you do not include the requested and relevant information in the online application and supplemental questionnaire. Applications and/or supplemental questionnaires that state, “see my resume” are considered incomplete and will not be considered to be competitive.

WORK SCHEDULE/CONDITIONS: This position is exempt from the provisions of the Fair Labor Standards Act, and is not eligible for overtime. Typical hours are Monday - Friday 8am - 5pm. 

Teleworking Requirement 

The work associated with this position will be performed through a combination of teleworking complemented with onsite work and meetings as needed. Employees will have access to shared workspaces at various King County facilities. Employees must reside in Washington state and within a reasonable distance to their King County worksite to respond to workplace reporting requirements.

Employees will be provided with a County issued laptop and must maintain a workspace with an internet connection (access may be supplemented in some situations) where they can reliably perform work and remain available and responsive during scheduled work hours. Please note that when an employee conducts work that is likely to bring them in contact with another individual, safety precautions are requiredincluding the wearing of masks in some situations. King County is doing its part to reduce the spread of COVID-19 and remains committed to reducing our carbon footprint.

King County has a robust collection of tools and resources to support working remotely. The individual selected for this opportunity will be joining an innovative and progressive team that is redefining how we work as we transition to the department's hybrid environment.  

RECRUITER: Annette Coleman, annette.coleman@kingcounty.gov 

Job Duties

  • Under the direction of the KCICN Administrator and in collaboration with internal and external partners, support the development, implementation, monitoring, and communication of BHRD programs, policies and IT systems to achieve optimal operational efficiencies and meet contractual and regulatory requirements internally within BHRD and across the network of contracted Medicaid and non-Medicaid providers.
  • Lead implementation, design and integration of new managed care operational functions, including adaptation of functional areas to meet new regulatory requirements, program policy, program design, process improvements and data analytics and business intelligence.
  • Oversee development and implementation of day to day managed care operations across functional areas, including implementation of standardized, scalable and sustainable processes that meet requirements for BH-ASO and IMC services under contracts with HCA and MCOs, respectively.
  • Oversee, supervise, and support BHRD functional Analyst staff who ensures a high level of data quality within BHRD as well as data submitted from contracted providers and provide user support related to information system functioning both for the provider community and BHRD staff.
  • Serve as a key participant in the IMC Joint Operations Committee, an essential working committee between BHRD, select providers, and all MCO contract administrators to identify key requirements, detail business rules and technical specifications, and develop design strategies for implementation.
  • Support development and implementation of integration pilots, and coordinate and collaborate with external partners and stakeholders, including MCOs, to achieve identified outcomes.
  • Represent BHRD needs related to business rules and program design to the information system and operations staff and vendors.
  • Support onboarding of Netsmart as new information system platform and electronic health record system for King County, including but not limited to developing use cases and future state business requirements.
  • Collaborate with the BHRD Performance, Measurement, and Evaluation team members and other Division staff as needed to detect and describe system-wide trends pertaining to quality.   
  • Collaborate with key external stakeholders, including managed care plans, behavioral health providers, State regulatory agencies and IT vendors.
  • Oversee the Information Systems Advisory Committee (ISAC), comprised of Data and Technical Systems representatives of the provider network.
  • Perform other related duties as assigned.

Experience, Qualifications, Knowledge, Skills

  • Bachelor's Degree and/or at least 5 years of professional experience in public sector behavioral health, primary care health services, electronic health record sector, or within a health insurance plan; or an equivalent combination of experience, education and/or training that provides the knowledge, skills and abilities to perform the work.
  • Strong ability to synthesize and analyze complex data, including large data sets, and conduct program evaluation.
  • Experience working as a director or manager of operational functions in the health or behavioral health sector including at an insurance, health system or electronic health record organization.
  • Experience working with healthcare or social service systems at the national, local, regional, or state levels, including but not limited to systems that serve low-income & vulnerable clients.
  • Knowledge of and experience with federal, state, and regional rules, regulations, and contract requirements pertaining to behavioral health managed care (e.g., CFR, RCW, WAC).
  • Knowledge of and experience with Medicaid managed care organizations in Washington State.
  • Knowledge of and experience with substance use disorder and mental health services in King County and/or Washington State or equivalent experience in another state.
  • Experience facilitating/leading large workgroups/committees with stakeholders and key partners.
  • Proven ability to work effectively with individuals who may have markedly different perspectives.
  • Strong written and verbal communication skills.
  • Ability to manage multiple tasks simultaneously.
  • Excellent interpersonal skills.
  • Strong knowledge of Office 365, e-mail, OneNote, Microsoft teams and excel.  
  • Valid Washington State Driver's License or the ability to travel throughout the county in a timely manner.
  • Graduate degree with coursework in social or health care administration or an equivalent combination of experience and education.

Supplemental Information

Forbes recently named King County as one of Washington State's best employers.

Together, with leadership and our employees, we're changing the way government delivers service and winning national recognition as a model of excellence. Are you ready to make a difference? Come join the team dedicated to serving one of the nation's best places to live, work and play.

Guided by our "True North", we are making King County a welcoming community where every person can thrive. We value diversity, inclusion and belonging in our workplace and workforce. To reach this goal we are committed to workforce equity. Equitable recruiting, support, and retention is how we will obtain the highest quality workforce in our region; a workforce that shares and will help advance our guiding principles--we are one team; we solve problems; we focus on the customer; we drive for results; we are racially just; we respect all people; we lead the way; and we are responsible stewards. We encourage people of all backgrounds and identities to apply, including Native American and people of color, immigrants, refugees, women, LGBTQ+, people living with disabilities, and veterans.

Covid-19 Vaccination Requirement

As of October 18, 2021, most* King County employees are required to be fully vaccinated against COVID-19. If hired, you will be required to submit proof of vaccination by October 18th. People are considered fully vaccinated two weeks after their second dose in a two-dose series or two weeks after a single-dose vaccine. Employees may make requests for a reasonable accommodation based on a medical disability or for sincerely held religious beliefs. Philosophical, political, scientific, or sociological objections to vaccination will not be considered for an exemption or accommodation.

This directive applies to employees in the Executive branch*, the Assessor's Office, Elections, the King County Sheriff's Office, and the Executive Office.

King County is an Equal Employment Opportunity (EEO) Employer

No person is unlawfully excluded from employment opportunities based on race, color, religion, national origin, sex (including gender identity, sexual orientation and pregnancy), age, genetic information, disability, veteran status, or other protected class. Our EEO policy applies to all employment actions, including but not limited to recruitment, hiring, selection for training, promotion, transfer, demotion, layoff, termination, rates of pay or other forms of compensation.

To Apply

If you are interested in pursuing this position, please follow the application instructions carefully. If you need this announcement in an alternate language or format, would like to request accommodation or assistance in the application or assessment process or if you have questions please contact your recruiter listed on this job announcement.

King County offers a highly-competitive compensation and benefits package designed to meet the diverse needs of our employees and support our employees' health and well-being.  Eligible positions receive the following benefits and have access to the following programs:

  • Medical, dental, and vision coverage: King County pays 100% of the premiums for eligible employees and family members
  • Life and disability insurance: employees are provided basic coverage and given the opportunity to purchase additional insurance for both the employee and eligible dependents
  • Retirement: King County employees are eligible to participate in a pension plan through the Washington State Department of Retirement Systems and a 457(b) deferred-compensation plan
  • Transportation program and ORCA transit pass
  • 10 paid holidays each year (plus 2 personal holidays)
  • Generous vacation and paid sick leave
  • Paid parental leave, family and medical leaves, and volunteer leave
  • Flexible Spending Account
  • Wellness programs
  • Onsite gyms and activity centers
  • Employee giving program
  • Employee assistance programs
  • Flexible schedules and telecommuting options, depending on position
  • Training and career development programs
For additional information about employee benefits please visit our Benefits, Payroll, and Retirement Page.

This is a general description of the benefits offered to eligible King County employees, and every effort has been made to ensure its accuracy.  If any information on this document conflicts with the provisions of a collective bargaining agreement (CBA), the CBA prevails.  Also, in the event of any incorrect information in this document, applicable laws, policies, rules, CBAs, or official plan documents will prevail.
NOTE:  Benefits for Term Limited Temporary (TLT) or Short Term Temporary (STT) positions, including leave eligibility and/or participation in the pension plan through the Washington State Department of Retirement Systems, will vary based upon the terms and details of the position. Short Term Temporary positions are not eligible for an ORCA transit pass.
For inquiries about the specifics of this position, please contact the recruiter identified on this job posting.

Are you applying to this position as an eligible Current or Previous King County Employee Priority Placement Program Participant AND Is this position the same or lower percentage of full-time when compared to the position held at the point of the notification of layoff AND Do you possess the skills and abilities to qualify for this position?
  • Yes, I was given a layoff notice from my role at King County AND I am within two years of the effective date of my layoff. AND The position I was laid off from was the same or a higher percentage of FT status when compared to this one.
  • No.
If you answered yes to the question above and you are applying for this position as a Priority Placement Participant, to be considered, you must provide the following three pieces of information in the space provided: 1. The title you held when you received your layoff notice 2. The department you worked in 3. The effective date of your layoff
Tell us about your professional experience in public sector behavioral or primary care health services, or within a managed care organization. List the organization name(s) and dates.
Please describe what you believe are the key characteristics of an integrated health care system.
This position serves as a business representative for the Behavioral Health and Recovery Division to multiple functions specific to the King County Integrated Care Network (KCICN), including but not limited to clinical, quality, data analytics and King County IT. Please succinctly describe an experience when you had to represent business needs and how you helped others to understand those needs in order to maintain business operations.
This is a three-part question about equity and social justice, which is integral to the work we do in King County. a) How do you define equity? b) How have you worked to incorporate an equity lens in your current or previous jobs? c) What would meaningful progress look like in King County?

Required Question