Apple Health Eligibility and Access Director (EMS4/AHA)

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.

Supplemental Information

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 programs
• Learn 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:

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.

Application Directions

To be considered, you must complete the online application in full and submit all required materials. Incomplete applications or applications missing required materials will not be considered. When completing your application, please include the following required materials:

• Cover letter: describing your qualifications for this specific position
• Resume: that details your applicable experience and education.
• Three (3) professional references: References must be entered directly into the designated references section of your application. We require 3 professional references including at least one current or recent supervisor.

We encourage you to apply! If you meet the required qualifications for this position; we want to hear from you. Desired qualifications describe additional experience, knowledge or skills that may be helpful in the role, but they are not required to be considered for the position. We welcome applicants with different backgrounds, experiences, identities, and perspectives.

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.

Need accommodations or have questions? If you have questions, need assistance with the application process, require an accommodation, or would like to request this posting in an alternative format, please contact Jake Nelko, human resources consultant – recruiter, at HCAjobs@hca.wa.gov and reference the recruitment title and job number in the subject line.

Technical Support : Reach out to NEOGOV directly at 1-855-524-5627 for technical support and login issues.

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More than Just a Paycheck!

Employee benefits are not just about the kind of services you get, they are also about how much you may have to pay out of pocket. Washington State offers one of the most competitive benefits packages in the nation.

We understand that your life revolves around more than just your career. Like everyone, your first priority is ensuring that you and your family will maintain health and financial security. That's why choice is a key component of our benefits package. We have a selection of health and retirement plans, paid leave, staff training and other compensation benefits that you can mix and match to meet your current and future needs.

Read about our benefits:

The following information describes typical benefits available for full-time employees who are expected to work more than six months. Actual benefits may vary by appointment type or be prorated for other than full-time work (e.g. part-time); view the job posting for benefits details for job types other than full-time.

Note: If the position offers benefits which differ from the following, the job posting should include the specific benefits.

Insurance Benefits

Employees and their families are covered by medical (including vision), dental and basic life insurance. There are multiple medical plans with affordable monthly premiums that offer coverage throughout the state.

Staff are eligible to enroll each year in a medical flexible spending account which enables them to use tax-deferred dollars toward their health care expenses. Employees are also covered by basic life and long-term disability insurance, with the option to purchase additional coverage amounts.

To view premium rates, coverage choice in your area and how to enroll, please visit the Public Employees Benefits Board (PEBB) website. The Washington Wellness program from the Health Care Authority works with PEBB to support our workplace wellness programs.

Dependent care assistance allows the employee to save pre-tax dollars for a child or elder care expenses.

Other insurance coverage for auto, boat, home, and renter insurance is available through payroll deduction.

The Washington State Employee Assistance Program promotes the health and well-being of employees.

Retirement and Deferred Compensation

State Employees are members of the Washington Public Employees' Retirement System (PERS). New employees have the option of two employer contributed retirement programs. For additional information, check out the Department of Retirement Systems' web site.

Employees also have the ability to participate in the Deferred Compensation Program (DCP). This is a supplemental retirement savings program (similar to an IRA) that allows you control over the amount of pre-tax salary dollars you defer as well as the flexibility to choose between multiple investment options.

Social Security

All state employees are covered by the federal Social Security and Medicare systems. The state and the employee pay an equal amount into the system.

Public Service Loan Forgiveness

If you are employed by a government or not-for-profit organization, and meet the qualifying criteria, you may be eligible to receive student loan forgiveness under the Public Service Loan Forgiveness Program.

Holidays

Full-time and part-time employees are entitled to paid holidays and one paid personal holiday per calendar year.

Note: Employees who are members of certain Unions may be entitled to additional personal leave day(s), please refer to position specific Collective Bargaining Agreements for more information .

Full-time employees who work full monthly schedules qualify for holiday compensation if they are employed before the holiday and are in pay status for at least 80 nonovertime hours during the month of the holiday; or for the entire work shift preceding the holiday.

Part-time employees who are in pay status during the month of the holiday qualify for the holiday on a pro-rata basis. Compensation for holidays (including personal holiday) will be proportionate to the number of hours in pay status in the month to that required for full-time employment, excluding all holiday hours. Pay status includes hours worked and time on paid leave.

Sick Leave

Full-time employees earn eight hours of sick leave per month. Overtime eligible employees who are in pay status for less than 80 hours per month, earn a monthly proportionate to the number of hours in pay status, in the month to that required for full-time employment. Overtime exempt employees who are in pay status for less than 80 hours per month do not earn a monthly accrual of sick leave.

Sick leave accruals for part-time employees will be proportionate to the number of hours in pay status, in the month to that required for full-time employment. Pay status includes hours worked, time on paid leave and paid holiday.

Vacation (Annual Leave)

Full-time employees accrue vacation leave at the rates specified in WAC 357-31-165(1) or the applicable collective bargaining agreement (CBA). Full-time employees who are in pay status for less than 80 nonovertime hours in a month do not earn a monthly accrual of vacation leave.

Part-time employees accrue vacation leave hours in accordance with WAC 357-31-165(1) or the applicable collective bargaining agreement (CBA) on a pro rata basis. Vacation leave accrual will be proportionate to the number of hours in pay status, in the month to that required for full-time employment.

Pay status includes hours worked, time on paid leave and paid holiday.

As provided in WAC 357-58-175, an employer may authorize a lump-sum accrual of vacation leave or accelerate the vacation leave accrual rate to support the recruitment and/or retention of a candidate or employee for a Washington Management Service position. Vacation leave accrual rates may only be accelerated using the rates established WAC 357-31-165.

Note: Most agencies follow the civil service rules covering leave and holidays for exempt employees even though there is no requirement for them to do so. However, agencies are required to adhere to the applicable RCWs pertaining holidays and leave.

Military Leave

Washington State supports members of the armed forces with 21 days paid military leave per year.

Bereavement Leave

Most employees whose family member or household member dies, or for loss of pregnancy, are entitled to five (5) days of paid bereavement leave. In addition, the employer may approve other available leave types for the purpose of bereavement leave.

Additional Leave

Leave Sharing

Parental Leave

Family and Medical Leave Act (FMLA)

Leave Without Pay

Please visit the State HR Website for more detailed information regarding benefits.

Updated 01-07-2026