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State of Washington Classified Job Specification

MEDICAL PROGRAM SPECIALIST 2

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MEDICAL PROGRAM SPECIALIST 2
162F
Category: Financial Services

Definition

In the Health Services Analysis Office of the Department of Labor and Industries and in the Department of Health, leads professional staff engaged in the review, analysis, and monitoring of health care cost containment programs.  Positions independently develop, plan, evaluate, promulgate policies and provide consultative services to medical providers and/or department staff regarding program administration.

Typical Work

Leads professional staff engaged in the review, analysis, and monitoring of health care cost program operations;  

Monitors performance of staff assigned to the unit in order to determine training needs, and provide technical assistance concerning interpretation of medical policy and procedures, program analysis, and monitoring activities;  

Plans, develops and evaluates time-limited studies for the review, analysis, and monitoring of health care cost containment programs; prepares reports on the time-limited studies on health care cost containment programs;  

Develops and coordinates implementation of program initiatives with division staff and/or staff from other program areas;  

Responds to inquiries from and prepares summary and status reports for Legislature, upper level division management, medical provider associations, other State agencies, and other interested parties;  

Reviews and evaluates State regulations, practices of other states, and publications for potential applicability to the health care cost containment program;  

Coordinates the development, interpretation and implementation of health care cost policies; promulgates administrative and procedural regulations for program implementation;  

Provides technical and consultative assistance to medical providers, and/or department staff, regarding the health care cost containment programs;  

Designs complex reporting systems; prepares instructions and develops training plans;  

Participates in research studies pertinent to the development of health care cost containment programs;  

Plans and develops strategy for analysis and reporting on medical providers and/or injured workers' utilization of medical services;  

Plans and develops strategy for analysis and reporting on medical provider delivery or injured worker utilization of medical services;  

Coordinates, develops and implements orientation and training needs for staff and medical providers; develops manuals and procedures;  

Performs other work 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, organize and direct programs; work effectively with program staff, providers, and other affected parties; analyze, interpret, 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 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 two 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.

Class Specification History

New class Effective July 15, 1988
Revised definition March 14, 1989
Revised definition and title change (formerly Medical Program Specialist 2, L&I) September 18, 1989
New class code: (formerly 54960) effective July 1, 2007

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