State of Washington Classified Job Specification
MEDICAL PROGRAM SPECIALIST 1
In the Health Services Analysis Office of the Department of Labor and Industries and in the Department of Health, performs medical analysis, evaluation, development, implementation, policy promulgation and/or contract administration in health care cost containment programs. Positions provide consultative services to medical providers and/or department staff regarding health care cost containment programs.
Confers with department staff in the development and implementation of program and procedural changes to assure compliance with department requirements, rules and regulations;
Takes full responsibility in conducting in-depth analysis of health care cost issues and programs by aiding in the preparation of project plans, conducting or leading data-gathering operations, analyzing data, reporting specific findings; develops, implements, and prepares project reports for written and/or oral presentation;
Provides technical and consultative assistance to medical providers and/or department staff regarding the health care cost programs; provides training for the medical provider community and adjudication staff of policy and program changes;
Analyzes and evaluates proposed legislation and program and policy changes to ascertain administrative feasibility;
Prepares and conducts economic feasibility studies relating to health care costs;
Assists in the design of complex reporting systems; checks reporting procedures to ensure validity;
Compiles technical information and writes analyses, summaries, histories, and briefs;
Develops, interprets, and implements changes to medical program policies; promulgates administrative and procedural regulations for program implementation;
Monitors program policies and procedures for adequacy and consistency, making recommendations in order to improve effectiveness of program;
Provides liaison and coordination between medical providers and department staff;
Provides consultative services to department staff and medical providers regarding program administration and policies;
Participates in the decision-making process and coordinates implementation of program changes from project recommendations;
Coordinates and consults with department staff regarding implementation, monitoring, and follow-up on project recommendations;
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; the legislative process.
Ability to: develop and evaluate programs; work effectively with program staff, medical 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.
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.
A Master's degree with major study in public health, public administration, nursing, health administration, economics, business administration, or closely allied field.
At least one year of consultative experience in the research and analysis of 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 1, L&I) September 18, 1989
New class code: (formerly 54950) effective July 1, 2007