Remote Lead Medical Assistance Specialist

State of Washington; Olympia (WA); Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Remote work and flexible schedules

Medical, dental, vision, and basiclife

Paid vacation, sick leave, 12 holidays

Paid Family and Medical Leave (PFML)

Retirement options

Training and professional development

Employee wellness programs

Job summary

Washington State Health Care Authority seeks a Medical Assistance Specialist 4 – Internal to lead a team handling pharmacy authorizations and training MAS staff. The role requires deep MAS expertise, policy interpretation, and cross-department collaboration to ensure accurate, compliant decisions.

You will mentor MAS3s, participate in audits, and help shape workflows while maintaining equity in service delivery and high-quality outcomes across Apple Health programs.

Qualifications

• Advanced knowledge of federal/state laws, regulations, policies relevant to complex medical assistance issues.
• Ability to analyze complex program issues and provide well-supported recommendations.
• Experience guiding staff on policy, procedures and work processes.
• Ability to develop and deliver formal training to promote consistent rule application.
• Experience reviewing work for quality, identifying trends and improving processes.
• Ability to interpret policies and communicate guidance to staff and stakeholders.
• Equity-focused decision making and inclusive service delivery.
• Commitment to continuous learning and growth.
• Ability to meet diverse client needs with empathy and clear communication.
• Experience with health care systems, Medicaid knowledge, and prior authorization requirements.

Responsibilities

• Lead Pharmacy Authorization Unit quality control to ensure proper protocol adherence.
• Coach MAS3s; supervise case management of pharmaceutical requests.
• Assist supervisor in reviewing complex authorization decisions.
• Consult with management on policies, problem solving, and workflows.
• Respond to online inquiries about authorizations, policies, and procedures.
• Utilize Provider One and related systems to process high-volume authorizations accurately.
• Monitor providers deviating from standards for compliance.

Skills

Advanced Medical Assistance Program.Ex

Advanced Analysis and Problem Res.

Technical Leadership and Guidance

Training and Knowledge Transfer

Quality Assurance and Program Cons.

Policy and Regulatory Interpretation

Equity lens

Action to learn and grow

Action to meet needs of others

Health Care Systems and Service Del.

Medicaid Knowledge

Client Complaint and Grievance

Medicaid Prior Authorization

Communication and Interpersonal Skills

Staff Training and Leadership

Six years experience/education (Pref)

Health benefits knowledge (Pref)

Public assistance eligibility (Pref)

Training and Leadership (Pref)

Job description

Washington State Health Care Authority seeks a Medical Assistance Specialist 4 – Internal to lead a team handling pharmacy authorizations and training MAS staff. The role requires deep MAS expertise, policy interpretation, and cross-department collaboration to ensure accurate, compliant decisions.

You will mentor MAS3s, participate in audits, and help shape workflows while maintaining equity in service delivery and high-quality outcomes across Apple Health programs.