Job Summary

This position is located within the Department of Health Care Finance (DHCF), Health Care Policy and Research Administration, Division of Regulation and Policy Management. The DHCF's mission is to improve health outcomes by providing access to comprehensive, cost-effective, and quality healthcare services for residents of the District of Columbia.

The incumbent serves as a Policy Analyst, responsible for reviewing, monitoring, and amending the Medicaid State Plan, managing federal waiver drafting and updating, and reviews and develops policy for administration of Medical Assistance programs administered or monitored by DHCF. These activities are based on sound analysis of local and national health care and reimbursement policies and strategies and ensuring coordination and consistency among health care and reimbursement policies developed by various administrations within DHCF.

Duties and Responsibilities

Reviews and develops long range, comprehensive health care services and health care financing plans and policies to meet present and future needs of persons eligible for the District's publicly funded health care programs. Reviews and monitors the Medicaid State Plan, manages the federal compliance of waivers, and analyzes, interprets, develops and coordinates policy and procedural documents that may become State Plan Amendments (SPAs) and/or waiver Amendments. Leads and participates in the evaluation of the scope, content, and priorities for DHCF programs and administrative responsibilities within the context of present and anticipated financial resources and assists with development of and justification for the annual DHCF budget.

Reviews and develops plans and policies in response to federal and state laws and regulations or at the request of the Supervisory Health Care Program Manager. Leads and performs independent research and analysis of the medical, demographic, legal, ethical, political, and financial components of DHCF programs and policies, and makes recommendations based on research findings. Independently researches public and private sector health care issues at the national, state and local levels to ensure that DHCF is informed of best practice standards, innovations, and trends in health care programs or medical assistance plans for people who are uninsured and underinsured. Ensures that SPAs and waivers conform to requirements of the Centers for Medicare and Medicaid Services (CMS), District laws and rules, Mayor's Orders and court decisions. Recommends revisions to existing or proposed legislation that are required for effective program implementation. Leads and participates in the coordination and alignment of strategic business planning and information technology planning to ensure that the technology infrastructure will support program planning and policy development needs. Reviews and recommends plans and policies to local and federal government officials and the City Council for approval prior to implementation.

Qualification and Education

Specialized Experience Experience that equipped the applicant with the particular knowledge, skills, and abilities to perform the duties of the position successfully, and this is typically in or related to the work of the position to be filled. To be creditable, at least one (1) year of specialized experience must have been equivalent to at least the next lower grade level in the normal line of progression.

LICENSES AND CERTIFICATIONS

None

WORKING CONDITIONS/ENVIRONMENT

The work is performed in an office setting and is sedentary in nature.

OTHER SIGNIFICANT FACTS

Tour of Duty: Monday Friday; 8:15 a.m. - 4:45 p.m.

Duration of Appointment: Career Service/Regular

Promotion Potential: No known promotion potential.

Pay Plan, Series and Grade: CS-0301-13

Collective Bargaining: This position is covered under a collective bargaining unit, American Federation of State, County and Municipal Employees (AFSCME), Local 2401, and is subject to union dues through payroll deduction

Position Designation: This position has been deemed security sensitive. Accordingly, the incumbent will be subject to pre-employment checks (criminal background, consumer credit check, traffic record check, and drug testing, if applicable) as a condition of employment, and will be subject to periodic criminal background checks for the duration of tenure.