State of Washington

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L&I Clinical Health Policy Manager

at State of Washington

Posted: 11/15/2019
Job Status: Full Time
Job Reference #: 2474956
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Job Description

Overall Job Objective

Description



 
Our Mission: Keep Washington Safe and Working!  Our Values: Customer Focus, One L&I, Respect, Diversity, Equity and Inclusion, Learning and Growth, Reliability.
 
Washington is America's Top State according to U.S. News (2019) and we provide one of the most competitive benefits packages in the nation.  Here at the Department of Labor & Industries (L&I), we believe that your voice matters.  We value our employees and offer flexible schedules that respect your work/life balance.  In addition, L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3 million workers. Learn more about L&I, the employer of choice here

Within L&I, our Office of the Medical Director (OMD) helps to prevent and reduce long-term disability by ensuring injured workers receive safe, effective and cost-efficient medical care.  As a Clinical Health Policy Manager you will support our mission by providing high quality health care to help injured workers heal and return to work.  You will also work with your team, the community and providers in developing and implementing health policies, as well as providing training and tools to improve compliance with health policies.  

Your ability to develop and maintain professional relationships with staff, advisory committees, self-insured employers, Third Party Administrators, and health care providers throughout the state will be key to your success.  This is an amazing opportunity to develop your leadership skills, mentor ONCs', and share your knowledge of the Workers' Compensation system.  If you want to be a part of a team that is passionate about making a positive difference in injured workers' lives, then we encourage you to apply now!

Duties

Some of what you'll do:

  • Supervise and mentor the health policy unit staff (medical program specialists, epidemiologist, and ONC's) in the resolution of complex medical treatment issues that arise with a workers' compensation claim.
  • Develop and adjust performance measures and set unit goals.
  • Lead the strategic planning, development and evaluation of evidence based health care policies and projects, including coverage decisions, and medical/surgical treatment guidelines.
  • Identify appropriate questions related to cost and utilization data.
  • Partner with appropriate stakeholders in evaluating how policies and guidelines will be applied and support the training of staff who will use them.
  • Provide clinical consultation and advice to self-insurance staff regarding health care delivery programs, medical devices and procedures, and health care issues.
  • Learn the department's Utilization Review (UR) and other clinical criteria programs, including an understanding of the roles and data systems used in the UR program.

Qualifications

Required Qualifications:

  • Bachelor's degree of Science in Nursing and a valid Washington State Registered Nurse license, or current license in any of the 50 states or territories and able to obtain a WA State license.
  • Five (5) years of clinical nursing experience.
  • Two (2) years of supervisory experience.
Desired Qualifications:

  • Master's degree in a health care discipline.
  • Two (2) years of nursing consultative, administrative, or supervisory experience over registered nursing staff or other health care professionals.
  • Experience with health care research and data analysis.

Supplemental Information

Application Process:  
The top candidates will be contacted directly to interview for this position. Because the selection will be based on information provided by you, it is in your best interest to identify the knowledge, skills and abilities that address the mandatory and desirable qualifications described below.

Please include the following documents with your application:
1. A letter of interest describing specific qualifications.
2. A current resume detailing applicable experience and education.
3. A list of at least three professional references with current telephone numbers.

Other Information:

  • Prior to any new hire into L&I, a background check, including criminal record history, will be conducted.
  • This position is represented by the Washington Federation of State Employees (WFSE).  
  • Employees driving on state business shall have a valid driver's license.  If driving a privately owned vehicle on state business, must be insured.
Applicants wishing to claim Veterans Preference should attach a copy of their DD-214 (Member 4 copy), NGB 22, or signed verification of service letter from the United States Department of Veterans Affairs to their application. Please blackout any personally identifiable data such as social security numbers. For further information please contact us at: Jobs@Lni.wa.gov
 

The State of Washington is an equal opportunity employer. Persons with a disability who need assistance in the application process or testing process, or those needing this announcement in an alternative format, may call (360) 902-5700. TTY users should first call 711 to access the Washington Relay Service.  
 
You are welcome to include the name and pronoun you would like to be referred to in your materials and we will honor this as you interact with our award-winning diverse and inclusive organization.

If you have any questions regarding this announcement, program, or the agency please contact Ashley Harris at haaw235@lni.wa.gov.