Medicaid and Non-Medicaid Benefits Program Manager, Project/Program Manager III

King County, WA; Seattle (WA); Hybrid; USD 95,000 - 135,000; Full time

Job summary

King County's Department of Community and Human Services (DCHS) seeks a Medicaid and Non-Medicaid Benefits Program Manager, Project/Program Manager III, to oversee Medicaid enrollment and spenddown operations for behavioral health services. You will provide technical assistance to providers, ensure contract compliance, manage non-Medicaid budgets (> $12M), and coordinate with state partners.

This hybrid role based in Seattle requires equity-driven leadership, strong policy knowledge, and

Qualifications

• Knowledge of federal and Washington Medicaid rules.
• Minimum three years of experience in supporting or managing programs in behavioral health or related field.
• Experience with state Medicaid systems such as ProviderOne.
• Experience developing or contributing to updates of policies, procedures, or operational guidance.
• Experience developing materials and providing training and technical assistance with providers, partners, or internal staff.
• Strong written and verbal communication skills.
• Commitment to equity and social justice in program design and implementation.
• Experience working with culturally diverse populations.

Responsibilities

• Develop job aids to support consistent staff and provider workflows.
• Develop and maintain program policies and procedures.
• Monitor and enforce contract requirements for program compliance.
• Oversee and monitor local BH provider performance in Medicaid coverage and spenddowns.
• Provide continuous technical assistance to support provider performance and Medicaid enrollment.
• Lead provider-facing meetings to communicate expectations and gather feedback.
• Create and maintain tools, guides, and training materials on spenddown processes.
• Coordinate with state Medicaid partners to clarify policy and updates.
• Track spenddown processes and inform program improvements.

Skills

Medicaid rules knowledge

Program management

Behavioral health knowledge

Policy development

Training and TA

Education

Bachelor's degree in a relevant field

Behavioral health credential (MHP or SUDP)

Tools

ProviderOne

Job description

Summary

King County's Department of Community and Human Services (DCHS) provides equitable opportunities for people to be healthy, happy, and connected to community.

At King County Department of Community and Human Services (DCHS), we believe in working as one team that solves problems—striving to be customer-focused and drive for the best results. We envision a welcoming community that is racially just. We believe the field of human services exists to undo and mitigate unfair structures. We seek to lead the way by working as respectful and responsible stewards for our community. The Medicaid and Non-Medicaid Benefits Program Manager, Project/Program Manager III, in the Utilization Management and Clinical Coordination section of the Behavioral Health and Recovery Division (BHRD), plays a critical role in helping King County residents access Medicaid and non-Medicaid Behavioral Health benefits and stewarding King County’s behavioral health investments for non-Medicaid mental health and substance use disorder (SUD) outpatient services. This position supports King County Behavioral Health providers by organizing resources and delivering technical assistance to help them guide individuals through Medicaid and non-Medicaid benefit processes. The role focuses on assisting providers with activities such as helping individuals qualify for initial Medicaid coverage, supporting individuals in meeting federal requirements for Medicaid renewal, facilitating “spenddowns” to initiate Medicaid eligibility, and connecting individuals to non-Medicaid benefits. They are a critical connector across providers, BHRD internal teams, and system partners—facilitating alignment, resolving operational issues, and ensuring consistent implementation of policies, procedures, and contract requirements related to Medicaid and non-Medicaid enrollment. The position will entail highly detailed and technical work, assisting with development and monitoring compliance with complex processes and system navigation, allowing for improved access to critical benefits for those with significant behavioral health care needs. This position also oversees the MIDD funded non-Medicaid program, with an annual budget of more than $12 million. This position ensures that these limited non-Medicaid resources are used effectively, equitably, and in alignment with King County’s commitment to a racially just, person centered behavioral health system. This role is responsible for managing and monitoring the non-Medicaid outpatient budget, overseeing program operations, and ensuring providers have the guidance, tools, and support needed to deliver non-Medicaid services. The position reports to the Utilization Management and Clinical Coordination Section Manager and functions as a subject matter lead for Medicaid enrollment and non-Medicaid program operations, provider support, and internal coordination. The Medicaid and Non-Medicaid Benefits Program Manager, Project/Program Manager III ensures that program expectations are clear, workflows are consistent, and spending aligns with established strategic priorities and contractual obligations. This recruitment is to fill a Term-Limited Temporary (TLT) position that is anticipated to be three (3) years in duration. If filled by a King County employee who has passed their initial probation, the TLT will be as a Special Duty Assignment (SDA).

Job Duties

• Develop job aids that support consistent staff and provider workflows.
• Develop, maintain, and implement program policies and procedures.
• Develop and maintain scope within the Provider Manual to ensure clear and current operational guidance and contract compliance requirements.
• Monitor and enforce contract requirements to ensure program compliance.
• Oversee and monitor local BH provider performance in obtaining Medicaid coverage for eligible clients (including initial enrollment, re-enrollment, and accomplishing spenddowns)
• Oversee and document internal non-Medicaid approvals.
• Facilitate steering committee sessions to drive alignment, decision-making, and program direction.
• Coordinate and facilitate internal meetings to ensure cross-team clarity and progress.
• Collaborate with other sections to align processes, resolve issues, and support integrated program operations.
• Provide continuous technical assistance to support provider performance, program fidelity, and Medicaid enrollment/re-enrollment.
• Lead provider-facing meetings to communicate expectations, gather feedback, and resolve operational issues.
• Manage the non-Medicaid inbox to ensure timely, accurate responses to provider inquiries.
• Serve as the division’s subject matter expert on Medicaid eligibility rules, coverage pathways, and qualifying criteria.
• Guide providers and internal staff on how to support individuals through Medicaid enrollment and re-enrollment processes.
• Track, manage, and communicate spenddown processes and expectations.
• Provide expert consultation on spenddown requirements, documentation, and best practices for minimizing gaps in coverage.
• Create and maintain tools, guides, and training materials that help providers understand spenddown processes.
• Act as a liaison with state Medicaid partners to clarify policy, resolve systemic issues, and communicate updates to providers.
• Monitor trends in Medicaid eligibility, enrollment challenges, and spenddown utilization to inform program improvements.
• Perform other related duties as assigned.

Experience, Qualifications, Knowledge, Skills

WE ARE LOOKING FOR CANDIDATES WHO HAVE:

• Knowledge of federal and Washington state Medicaid rules and law.
• Minimum three years of experience in supporting or managing programs in behavioral health, public health, human services, or a closely related field.
• Experience with state Medicaid systems such as ProviderOne.
• Experience developing or contributing to updates of policies, procedures, or operational guidance.
• Experience developing materials and providing training and technical assistance experience with providers, community partners, or internal staff.
• Demonstrated ability to communicate clearly and concisely—written, verbal, and interpersonal.
• Interest in state Medicaid eligibility policy, development of routes for accessing benefits and navigating complex systems, and highly detailed and technical work.
• Proven ability to embody principles of equity, race, and social justice in the workplace
• Demonstrated commitment to equity and social justice in program design and implementation.
• Analytical and improvement mindset with the ability to evaluate successes and failures and adapt to change.
• Experience working with culturally diverse populations.

Desired Qualifications

• Knowledge of Washington State BH-ASO and KCICN structures and related regulatory frameworks.
• Experience with King County behavioral health providers or contracted agency operations.
• Medicaid eligibility and enrollment expertise, including spenddown processes, coverage pathways, and navigation of complex cases.
• Experience resolving Medicaid enrollment barriers or supporting complex eligibility cases.
• Experience managing budgets or financial processes.
• Experience facilitating meetings with diverse stakeholders, including providers, internal teams, and system partners.
• Experience conducting contract compliance monitoring for behavioral health providers.
• Quality improvement or process redesign experience.
• Program data analysis experience to inform operational decisions.
• Qualified behavioral health credential — Current and active Mental Health Professional (MHP) as defined in WAC 71.34, 18.225, 18.19, and 18.83 and RCW 71.05.020; or a Substance Use Disorder Professional (SUDP) as defined in WAC 246-811-010 and RCW 18.205.

Additional Position Information

• This position has been designated Non-Mission Critical. Unless otherwise directed by the County Executive, department director or agency head, all employees, regardless of designation, are expected to report to work or request leave during an emergency or inclement weather. For more detailed information, please visit HR Policy County Operations During Emergency Situations and the King County Guidelines for Workforce Management in an Emergency.
• This Utilization Management and Clinical Coordination Section of BHRD works in a hybrid model, with days in the office as well as telecommuting. The ratio of remote to onsite work will be dependent on business needs and is subject to change. The primary onsite location is Chinook, 401 5th Ave, Seattle, WA 98104. Employees must reside in Washington state and within a reasonable distance to their King County worksite to respond to workplace reporting requirements.

King County has a robust collection of tools and resources to support working remotely. The individual selected for this opportunity will join an innovative and progressive team that is redefining how we work as we transition to the department's hybrid environment. Employees will be provided with a County-issued laptop and must maintain a home workspace with an internet connection where they can reliably perform work and remain available and responsive during scheduled work hours.

• This position is exempt from the provisions of the Fair Labor Standards Act and is not eligible for overtime. Typical hours are Monday - Friday, 8am - 5pm.
• This position is not represented by a union.
• Classification: Project/Program Manager III

King County's Vision, Mission, and ACTIVATE Values unite us.

King County serves residents with a relentless sense of urgency, delivering on commitments with transparency and accountability. We are action-oriented, creative problem solvers who collaborate across roles, engage directly with communities, and challenge the status quo to achieve meaningful impact. As a unified team, we uphold high ethical and stewardship standards, embrace change, stay curious, and continuously improve. Across all interactions, we listen first, act quickly, and stay aligned as a team to earn and sustain public trust. Learn more about our Vision, Mission, and ACTIVATE Values here and visit our Why work at King County page here.

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