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State of Washington Classified Job Specification

MEDICAL PROGRAM SPECIALIST 3

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MEDICAL PROGRAM SPECIALIST 3
162G
Category: Financial Services

Definition

Directs and supervises a unit comprised of three or more professional staff engaged in the review, analysis, monitoring, and/or operation of health care cost containment programs; or, manages and directs the development of statewide health care initiatives and long-term purchasing improvement projects to ensure injured workers’ access to quality care. 

All positions in this classification are responsible for providing consultative expertise regarding heath care cost containment programs to top-level managers. 

Typical Work

Provides administrative direction to subordinate staff regarding system operations or projects and initiatives; 

Plans, directs, coordinates and evaluates the activities of subordinate managers and/or other professional staff; 

Establishes and directs administrative policy for a section; establishes goals and objectives for programs and staff;  

Directs the design and development of comprehensive statewide program reviews, plans, policies and procedures for medical provider service delivery; 

Organizes and administers audit review process;  

Supervises coordination of findings from audit reviews with professional staff to develop and implement specific policies for the health care programs; 

Prepares comprehensive, long-range plans relating to health care program objectives;  

Supervises the resolution of, and resolves, program issues arising from the audits of medical providers; 

Evaluates the effectiveness of health care program policies and initiatives and their impact on injured workers, medical providers and expenditures; 

Performs other duties as required.

Knowledge and Abilities

Knowledge of:  state policies and regulations related to health care programs; principles and practices of program planning and evaluation; current trends and economic problems relating to health care cost and the injured worker; health care organizations and industry; principles of supervision and staff development; the legislative process.   

Ability to:  develop, implement and evaluate programs; work effectively with program staff, providers, and other affected parties; analyze and resolve complex problems related to health care cost programs; communicate clearly and effectively both orally and in written form; select, train, supervise, and evaluate staff. 

Legal Requirement(s)

There may be instances where individual positions must have additional licenses or certification. It is the employer’s responsibility to ensure the appropriate licenses/certifications are obtained for each position. 

Desirable Qualifications

One year of experience as a Medical Program Specialist 2.  

OR 

Two years of experience as a Medical Program Specialist 1.

OR

A Master's degree with major study in public health, public administration, nursing, health administration, economics, business administration, or closely allied field AND three years of supervisory or consultative experience in a health services program.   

Two additional years of qualifying experience may be substituted for the Master's degree provided a Bachelor's degree in one of the above fields has been achieved.

OR 

Equivalent education/experience.

Class Specification History

New class adopted May 10, 2007, effective July 1, 2007.

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