Job Description

Recruitment InformationRecruitment Number 23-0677 - This vacancy is located in the Med-Quest Division, Health Care Services Branch of the Department of Human Services.Salary: $6,177 to $7,517 per month (SR-26, Step D to Step I)Note: Hiring rates will be based on availability of funds, the applicant\'s qualifications, and other relevant factors.A continuous recruitment may be closed at any time. The notice of the last day to file applications will be posted on the State of Hawaii\'s Civil Service Job Opportunities Listing page of our website.Duties SummaryThe General Professional VI plans, supervises and coordinates a staff of professional workers at the V level or supervises staff through subordinate supervisors at the V level; or serves as a technical expert in a highly specialized area and functions as the top-level essential to the development and direction of unprecedented initiatives having significant impact on all/most Executive Branch departments and which typically involves the application of state-of-the-art and/or "cutting edge" ideas, concepts, technology and/or issues; and performs other related duties as assigned.This position is located within the Department of Human Services, Med-QUEST Division, Health Care Services Branch. The branch administers and manages contracted Managed Care Organizations (MCO) and other contracts to deliver quality health care services to ensure compliance with applicable contracts, rules, regulations, and laws impacting MCO contracts and other contracts supporting physical health, behavioral health, long-term services and supports (LTSS) and social determinates of health. The purpose of this position is to develop alternative payment policy and programs to advance MQD\'s statewide initiatives toward reimbursing for quality and value. Duties and responsibilities include developing payment initiatives [i.e., Alternative Payment Models (APMs)] to advance MQD initiatives toward reimbursement, and architecting division policy direction and initiatives detailing how Value Based Payment arrangements will further MQD goals related to APMs.The purpose of this position is to develop alternative payment policy and programs to advance MQD statewide initiatives toward reimbursing for quality and value and not volume. This position shall architect division policy direction and initiatives detailing how Value Based Payment (VBP) arrangements will further Med-Quest Division goals related to Alternative Payment Models (APM).Minimum Qualification RequirementsTo qualify, you must meet all of the following requirements:Legal Authorization to Work:The State of Hawaii requires all persons seeking employment with the government of the State shall be citizens, nationals, or permanent resident aliens of the United States, or eligible under federal law for unrestricted employment in the United States.
Basic Education: Bachelor\'s degree from an accredited four-year college or university.General Experience: One (1) year of responsible professional work experience which required a high degree of analytical skill. Such experience must have involved gathering, evaluating and analyzing facts and other pertinent information required to resolve problems and/or to determine and recommend appropriate courses of action; demonstrated the ability to elicit information orally and in writing; reading, comprehending, interpreting and evaluating technical subjects, analysis or proposals; and applying problem solving methods and techniques, such as defining and analyzing problems, identifying alternative courses of action, using judgment in determining appropriate alternatives; and preparing clear and concise written reports and recommendations for action.The experience must have been comparable to the General Professional IV* or higher** in the State service AND must have provided the knowledge, skills and abilities required to perform the duties and responsibilities of this position:*General Professional IV: Independently performs complex professional work which involves considerable research and analysis of a variety of issues, identification of various options and recommendation of the most viable solution.**General Professional V: Independently performs highly complex professional work; supervises a staff of professional workers comparable to the IV level; serves as a project or team leader (e.g., initiates and completes highly complex projects, coordinates and directs a team of lower level professional workers, ensures accuracy and timely completion of work); or serves as a senior specialist requiring specialized technical knowledge in a particular subject matter area.**General Professional VI: Plans, Supervises and coordinates a staff of professional workers at the SR-24 level or supervises staff through subordinate supervisors at the SR-24 Level; or serves as a technical expert in a highly specialized area and functions as the top-level contributor essential to the development and direction of unprecedented initiatives having significant impact on all/most Executive Branch departments and which typically involves the application of state-of-the-art and/or cutting edge ideas, concepts, technologies and/or issues.Selective Certification Requirement (Data Governance Experience): In order to effectively perform the duties and responsibilities of this position, applicants MUST possess demonstrate knowledge of complex and diverse managed care delivery systems and national best practices in managed care; the impact and importance of primary services including behavioral health on downstream acute services and/or Long Term Services and Supports; basic Medicaid and Medicare financing mechanism; Federal rules, regulations, and standards relevant to health care services; and principles and practices of contract, negotiation and administration. Additionally, applicants must have the ability to analyze and evaluate health insurance reimbursement and utilization data; identify opportunities for new service delivery models, develop plans and oversee implementation of models; effectively communicate program goals and objectives to impact change; adhere program framework to external regulatory standards; exercise sound judgement in applying remedies consistently in different scenarios and presentations; and manage relationships with providers, provider groups, provider associations, community stakeholders and regulators.Therefore, certification of eligibles for this position shall be restricted to those applicants who meet the minimum qualification requirements of the General Professional VI class of work, and whose professional work experience includes at least One (1) year of responsible professional work experience in designing and implementing Alternative Payment Models (APM) for health care services provided through contracts with health plans, individual providers, health care institutions, or self-funded insurance programs for a large employer. Including evaluation of effectiveness and continuous improvement of APMs over time.Substitution Allowed: Relevant substitution as described in the Minimum Qualification Requirements, will apply.The information provided above represents a summary of the complete Minimum Qualification Requirements. To view the Requirements in their entirety, please .02008:020612:13:CLAOther InformationThe State of Hawai\'i complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If you require reasonable accommodations in completing an application, any pre-employment testing, or otherwise participating in the selection process, please call 808-587-0936 for assistance.PUBLIC SERVICE LOAN FORGIVENESS (PSLF) PROGRAM
The PSLF Program is a federal program that is intended to encourage individuals to work in public service by forgiving the balance of their federal student loans. To qualify, the individual must have made 120 qualifying payments while employed by a qualifying employer. For more information, please click:ELECTRONIC NOTIFICATION TO APPLICANTS
The Department of Human Resources Development (HRD) will use electronic mail (email) to notify applicants of important information relating to the status and processing of their applications as part of our ongoing efforts to increase operational efficiency, promote the conservation of green resources, and minimize delays and costs.Please ensure that the email address and contact information you provide is current, secure, and readily accessible to you. We will not be responsible in any way if you do not receive our emails or fail to check your email-box in a timely manner. In addition, please be aware that you may no longer receive notification about applications submitted if you choose to disable the Job Application Emails feature in your Account Settings.TESTING INFORMATION
The examination for this recruitment will be conducted on an unassembled basis where the examination score is based on an evaluation and rating of your education and experience. It is therefore important that your employment application provide a clear and detailed description of the duties and responsibilities of each position you held.In-person interviews and/or further testing in Hawaii may be required at the discretion of the hiring agency. If in-person interviews and/or further testing are required, applicants who meet the minimum qualification requirements and are referred to the vacancy must be available to participate in person and at their own expense in this phase of the selection process.Applicants are encouraged to submit their applications as soon as possible. In addition to employment availability and score, the referral of qualified applicants may be based upon other factors including date of receipt of the application.for further information about Equal Employment Opportunity, the Merit Civil Service System, Citizenship and other requirements, Reasonable Accommodation, Veterans Preference, Examination Requirements, and the State Recruiting Office\'s Levels of Review.

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