Case Manager and Certification Specialist (HSC 3) DOH8969

About the role

The Opportunity
The Case Manager and Certification Specialist position (HSC 3) resides within the Office of Health Systems Oversight (OHSO), whose role is to support the department’s mission to work with others to protect and improve the health of people in the state of Washington by contributing to safe care and providing oversight of state-licensed and federally certified clinical and behavioral health entities, and by ensuring they meet applicable standards.

Responsibilities

• Oversee and direct the enforcement process of assigned healthcare facilities and programs.
• Cookordinate cross-office activities related to the complaint response process and enforcement activities relating to violations of state and federal laws, rules, and regulations for healthcare facilities.
• Assess complaints in preparation for case management team (CMT) panels for the initial authorization decision.
• Conduct research into applicable state and federal laws, rules, and regulations.
• Contact the complainant when necessary to ask preliminary questions to aid in the assessment decision.
• Identify and convene an Expedited Case Management Team (ECMT) meeting to discuss complaints involving apparent imminent danger or other challenging cases that could result in an enforcement action.
• Present concise and accurate summaries of the information contained in the case file to include the results from all the above research and analysis.
• Cookordinate, monitor, maintain, and update applicable state and federal databases.
• Provide technical assistance and consultation to internal and external database users to resolve technical problems.
• Process requests to create and close initial, routine, and re-visit inspections in the state and federal databases.
• Create inspection record in the federal database by determining regulation sets (WAC, RCW, or CFRs) for each request based on facility type, type of inspection, and the assigned surveyor.
• Create State Fire Marshal inspection record in the federal database for requested facilities with associated regulations.
• Provide consultation and technical assistance with the State Fire Marshal’s office regarding applicable facility regulations.
• Provide expertise in the implementation of the Medicare certification process and systems.
• Research and gather documentation for Public Records Requests (PRR) or Freedom of Information Act (FOIA) requests.
• Provide support and customer service that may be sensitive in nature to office staff and the public.

Qualifications

• Six (6) or more years of professional management or consultative experience in a health profession, healthcare facility, health services program, or closely allied field including demonstrated experience interpreting and applying state and federal laws, rules, and regulations.
• An associate’s degree; AND four (4) years of professional management or consultative experience in a health profession, healthcare facility, health services program, or closely allied field including demonstrated experience interpreting and applying state and federal laws, rules, and regulations.
• A bachelor’s degree; AND two (2) years of professional management or consultative experience in a health profession, healthcare facility, health services program, or closely allied field including demonstrated experience interpreting and applying state and federal laws, rules, and regulations.

Preferred Qualifications

• Four (4) or more years of professional management or consultative experience in a health profession, healthcare facility, health services program, or closely allied field to include: Experience working with and interpreting state laws or federal regulations related to licensed or certified healthcare facilities.
• Experience using complex healthcare-related databases, including inputting data, importing and exporting data, preparing standard reports, and interpreting electronic records in a variety of settings.
• Experience using Word processing software, such as Microsoft Word to create, format, and edit documents for report writing and other internal and external correspondence.
• A bachelor’s degree or higher in public health, health care administration, public or business administration, or other related field.