Apple Health Eligibility and Access Director (EMS4/AHA)

Washington State Health Care Authority; Olympia (WA); Hybrid; USD 180,000 - 260,000; Full time

Benefits offered by this job

Remote work options

Paid time off and holidays

Retirement options

Job summary

Washington State Health Care Authority seeks an Apple Health Eligibility and Access Director to lead a high-visibility division overseeing Medicaid, CHIP, and state-funded medical eligibility operations. The role balances policy development with day-to-day operational leadership, reporting to executive leadership in Olympia, WA.

The ideal candidate will drive strategic direction, ensure compliant and efficient eligibility processes, and manage a 300+ workforce while guiding major eligibility

Qualifications

• Experience with Medicaid/CHIP policy and eligibility programs.
• Ability to speak publicly and represent the division in various forums.
• Proven decision-making skills in personnel and policy/operational changes.
• Experience leading large-scale organizational change and system implementations.

Responsibilities

• Direct statewide Medicaid, CHIP, and state-funded medical eligibility operations.
• Set strategic direction and performance measures for Medicaid/CHIP eligibility.
• Ensure timely, accurate, and equitable eligibility determinations and renewals.
• Provide executive oversight of medical eligibility policy development and implementation.
• Oversee recruitment, hiring, and division budget planning.

Skills

Medicaid policy knowledge

Public speaking

Decision making

Education

Bachelor’s degree in health policy, health administration, business administration, public health, public administration, or related field

Associate degree in health policy, health administration, business administration, public health, public administration, or related field

Job description

Apple Health Eligibility and Access Director

This is a full-time permanent hybrid position. This position is required to report on-site in Olympia, WA, at least two times per week to meet business needs.

All HCA employees are required to be Washington state residents upon their first day of employment.

The Opportunity

This director oversees a new division consisting of previously existing teams whose work is focused on Apple Health (Medicaid) eligibility and access services. This highly visible role is a balance of overseeing policy work as well as day-to-day operations of the division.

Key Responsibilities

• Direct statewide Medicaid, CHIP, and state-funded medical eligibility operations.
• Establish strategic direction, priorities, performance measures, and operational objectives for Medicaid, CHIP, and state-funded medical assistance eligibility.
• Ensure timely, accurate, and equitable eligibility determinations and renewals.
• Lead organizational change initiatives to improve service delivery, efficiency, and outcomes.
• Provide executive oversight and direction of medical eligibility policy development and implementation.
• Interpret and operationalize complex federal and state statutes, regulations, and guidance.
• Ensure compliance with federal Medicaid and CHIP requirements, state laws, and agency policies.
• Represent the agency and the program in federal and state eligibility audits, reviews, and corrective action activities.
• Advise the Medicaid Director and executive leadership on policy, operational, fiscal, and regulatory impacts to Apple Health eligibility.
• Serve as appointing authority for a workforce of 300+ employees, both represented and non-represented, through senior leaders and front-line supervisors.
• Exercise authority for recruitment, hiring, promotion, reassignment, discipline, and separation decisions.
• Direct division budget planning, resource allocation, and fiscal accountability.
• Provide executive sponsorship and oversight for eligibility systems modernization and technology initiatives.

Why You’ll Love This Role

• Have a direct impact on Medicaid eligibility policy, which is constantly evolving, in a state where access and affordability are at the forefront of this work.
• Engage with the public in a role that is highly visible and directly impacts the clients we serve.
• Work to solve important and complex problems as Medicaid rules and laws change.

What You Bring

• Medicaid policy knowledge: You are familiar with, and excited by, policies and laws that govern the work of this division.
• Public speaking: You are confident representing the division’s work in public and political forums.
• Decision making: You are a composed decision-maker comfortable with handling responsibilities including personnel actions, policy decisions, and operational changes.

Required Qualifications

Experience may have been gained through paid or unpaid activities. Please ensure any relevant experience defined below is outlined in your cover letter, resume, and application.

Qualifying candidates will satisfy one of the following criteria options:

Option 1:

• Bachelor’s degree in health policy, health administration, business administration, public health, public administration, or other closely related field.
• Five (5) years of progressively responsible leadership experience in Medicaid, public health, human services, eligibility administration, health policy, or related programs, projects, teams, or operations in a represented environment.

Option 2:

• Associate degree in health policy, health administration, business administration, public health, public administration, or other closely related field.
• Seven (7) years of progressively responsible leadership experience in Medicaid, public health, human services, eligibility administration, health policy, or related programs, projects, teams, or operations in a represented environment.

Option 3:

• Nine (9) years of progressively responsible leadership experience in Medicaid, public health, human services, eligibility administration, health policy, or related programs, projects, teams, or operations in a represented environment.

Qualifying candidates will also satisfy all of the following qualifications:

• Three (3) years of senior level management experience (supervising other supervisors/managers).
• Experience leading large-scale organizational change, systems implementation, or business transformation initiatives.
• Demonstrated executive management skills and abilities, including project management, strategic leadership, quality and system improvement, fiscal management, and management of personnel issues.
• Demonstrated knowledge and expertise with state and federal Medicaid and CHIP program rules, requirements, and regulations, as well as the evolving federal Medicaid landscape.
• Demonstrated knowledge of regulatory interpretation and compliance related to state and federal Medicaid and CHIP regulations.
• Demonstrated experience effectively leading and developing staff, including managers, through coaching, mentoring, recognition, and performance feedback.
• Demonstrated experience effectively engaging with a diverse set of stakeholders to develop and implement policy and solve complex, multi-dimensional problems.
• Demonstrated proficiency working with multiple stakeholders, and facilitating and convening divergent groups to achieve a common goal.
• Demonstrated experience effectively adapting and leading staff through change within an agency or organization.
• Demonstrated ability to serve as a role model for ethical conduct and personal/professional standards.
• Demonstrated experience in promoting opportunities for development and a commitment to building a diverse workforce.
• Demonstrated knowledge of the complex relationships among policy, operations, technology, and customer experience and proven ability to make decisions that strengthen the overall system.

Required Competencies

• Equity lens – All HCA employees are required to consider equity in their decisions, processes, and day-to-day work, including how their work may affect the people and communities we serve.
• The ability to take action to learn and grow – You take action to learn and grow by seeking new perspectives, learning from experiences, and using what you’ve learned to continuously improve how you work and serve others.
• The ability to take action to meet the needs of others – You take action to meet the needs of others by listening, understanding different perspectives, and responding with care, respect, and solutions that support the people of the communities we serve.

Preferred Qualifications

While these are not required, having them may help you stand out as an applicant.

• Master’s degree in health policy, health administration, business administration, public health, public administration, or other closely related field.
• Lean Six Sigma Green Belt certification.
• Lean Six Sigma Black Belt certification.
• Prosci Change Management certification.
• Executive level experience in public medical assistance programs.
• Senior management level experience at a state government agency, including managing a large, complex operating budget.
• Thorough knowledge, experience and accountability in strategic leadership and planning in a complex, multi-service organization.
• Management and oversight of budgets, which include multiple sources of federal and state funds.

About the Division

The Apple Health Eligibility and Access (AHEA) division consists of the Medical Eligibility Determination Services (MEDS) office, the Eligibility Policy Innovation and Community Support (EPICS) office, and centralized operations. This position reports directly to the Medicaid and CHIP Director and plays a vital role in accomplishing the Health Care Authority’s mission. HCA promotes health care access to the uninsured, underinsured, and Tribes; it ensures that health technology and prescription drugs are safe and used effectively, and improve health and productivity of state employees, retirees, and their dependents. HCA’s mission is powered by the people we serve; we improve health across Washington by advancing equitable access to quality, whole-person care.

About the Washington State Health Care Authority

Better Health. Better Care. A Healthier Washington.

At HCA, we work to ensure people across Washington have the opportunity to be as healthy as possible. As the State’s largest health care purchaser and behavioral health authority, HCA serves nearly 3 million Washington residents through Apple Health (Medicaid), Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs, and behavioral health services. Through this work, HCA purchases and coordinates care coverage, supports behavioral health prevention, treatment, crisis response, and recovery and helps strengthen access to high-quality care across Washington.

More than a benefits package:

We want our employees to have the support, flexibility, and benefits they need to do their best work and build a career that works for their life. As a Washington State HCA employee, you’ll have access to a comprehensive benefits package that supports your health, financial well‑being, and work‑life balance. Our benefits are designed to support you today while helping you plan for the future. Learn more about why HCA by visiting the Voices of HCA and the "Who we are" section of our website.

Your total compensation is more than your paycheck:

• Remote work and flexible schedules
• Medical, dental, vision, and basic life insurance
• Paid vacation, sick leave, and 12 paid holidays
• Paid Family and Medical Leave (PFML)
• Retirement options to plan for the future
• Training and professional development opportunities
• Employee wellness programsLearn more about Washington State Employee Benefits

Work Location and Schedule

This is a full-time 40-hour-per-week hybrid position. You will report to the HCA office located in Olympia, WA for in-person work. Our standard business hours are Monday through Friday, 8 a.m. to 5 p.m., with alternative work schedules considered based on business needs. When working in-person, you will work in a shared space, open office environment. In this role you’ll regularly collaborate with colleagues, agency leaders, state and federal partners, and other external partners or customers. Occasional travel may be required for meetings, training, or other business needs. All employees are required to report to our Olympia office on their first and final day of employment.

Our commitment to an inclusive workplace:

The Health Care Authority is an equal opportunity employer. We are committed to creating a workplace where employees are respected, included, and supported in bringing their experiences, perspectives, and ideas to work.

Our commitment to inclusion is reflected in how we work together and serve the people of Washington. HCA also supports five voluntary employee led Employee Resource Groups (ERGs), which create opportunities for connection, community, learning, and professional growth.

Veterans:

We value the experience and skill veterans bring to the workforce and encourage veterans, transitioning service members, and military spouses to apply. Eligible veterans may qualify for veterans’ preference in accordance with Washington State Law. If you are claiming veterans’ preference, you must attach your applicable DD-214 documentation to your application. Please redact your social security number, date of birth, and any other sensitive information before uploading and attaching the document.

The Washington State Health Care Authority (HCA) is an E-Verify employer. All applicants with a legal right to work in the United States are encouraged to apply.

E-Verify® is a registered trademark of the U.S. Department of Homeland Security.