Associate Medical Director, Health Care Services (MD/CQCT)

About the Department

Associate Medical Director, Health Care Services (MD/CQCT)

71052688

This recruitment is posted continuously. Application review will begin on 6/11/2026 and you are encouraged to submit your application materials as soon as possible. The hiring manager reserves the right to close the posting at any time once a selection has been made.

We are in search of a dynamic health care problem solver for this policy-focused position that is responsible for all clinical decisions made for Apple Health (Medicaid) in the State of Washington. The associate medical director collaborates with agency leadership as well as internal and external partners to provide clinical input in the development of health policy with the aim of improving the lives of those covered by Medicaid. If you are looking for an opportunity to have a significant positive impact on these Washingtonians during a challenging juncture for Medicaid recipients, then consider applying for this opportunity!

All HCA employees will apply an equity lens to their work, which may include but is not limited to all analyses of core business and processes.

About the division:

The Clinical Quality and Care Transformation (CQCT) Division is responsible for designing and implementing clinical policy; conducting oversight, including measuring, monitoring, and improving all clinically-related programs; and communicating and collaborating with stakeholders, providers, plans, and delivery system partners on clinical activities and issues with the goal to provide a single standard of evidence-informed high-quality care. 

The CQCT Division is focused on four broad aims working with local, state, and national efforts to improve the quality of health care: 

• Better Care: Improve the quality of care, member experience and care delivery.
• Better Health: Improve the health of program members and Washingtonians.
• Lower Trend: Reduce the cost trends of health care for clients, families, Public Employees Benefits (PEB), and State government.
• Improved work life of health providers: Advance system changes to reduce physician burn-out. This effort is sometimes referred to as the quadruple aim. 

About the position:

This position provides clinical leadership to lead the state in care quality and transformation and supports the benefit programs administered by HCA. Leadership components include the consideration of health equity initiatives, social determinants of health, provider engagement, patient-centered care models, and value-based purchasing. This position works with public health entities, providers, insurers, and other stakeholders; defines clinical purchasing and funding strategies; aligns resources to goals and strategies; and implements and evaluates the results of clinical leadership efforts. This position supports care transformation, innovation, and value-based care delivery within Apple Health, Medicaid, impacting over 2.5M lives and $21B of annual expenditure.

The Associate Medical Director leads Apple Health's evidence-based clinical policies, Washington's Health Technology Assessment Program (HTAP), and provides clinical leadership for the nine Accountable Communities of Health (ACHs). This position reports directly to the Chief Medical Officer (CMO).

This position is eligible to telework but is frequently required to report on-site to meet business need.The default assigned work location of all Health Care Authority (HCA) positions – both on-site and telework eligible positions – is within the State of Washington. This position reports to Olympia, WA. Frequency of onsite work will vary based on business and operational needs. All agency employees are required to report on-site in Olympia on their first and last days of employment to pick up and return state-issued equipment, regardless of telework status or location. 

Position Duties

Some of what you will do:

Lead Apple Health clinical strategy

• Lead and support the HCA Health Care Services Section including medical, dental, and DME, and the medical and dental licensed prescribing practitioners. 
• Develop, review, and update clinical policies, protocols, and coverage standards based on review of medical literature, the best available evidence, the requirements of the Center for Medicaid and Medicare Services (CMS), state law, governor directive, and agency priorities. 
• Determine, with the CMO and Quality Measuring Monitoring and Improvement team, the most appropriate measures to assess the quality of care provided. 
• Facilitate care transformation efforts within HCA contracted provider systems. 

Apple Health Managed Care Measurement, Monitoring and Improvement

• Ensure clinical policies of Medicaid MCOs accurately reflect the intent and expectations of HCA and are implemented consistently across contracted plans so as to reduce practice variation, assure appropriateness of care and improve health equity. 
• Collaborate effectively with the Medicaid Program Division, Financial Services Division, and other HCA divisions as appropriate to achieve these ends. 
• Review and monitor MCO utilization management programs, case management initiatives, utilization review protocols, clinical components of post-payment review, and prior authorization (PA) policies 

Statewide Clinical Collaboration

• Participate in and, as appropriate, lead statewide clinical collaborations, such as those sponsored by the Washington Health Alliance, Bree Collaborative and others, as directed by the CMO.
• Develop and lead clinically-oriented statewide HCA initiatives housed in CQCT.

Evidence-based clinical policy development, implementation and oversight

• Lead the HTAP including topic selection, participating agency engagement, appointment of Health Technology Clinical Committee (HTCC) members, and the functioning of the committee. Participate as a clinical member of the Health Technology Assessment Workgroup. 
• Lead the HCA Coverage Parameters team and develop, review, and update clinical policies, as needed.
• Create and implement Apple Health clinical policy.
• Participate as a member of the Washington State Agency Medical Directors Group in the development and implementation of statewide clinical initiatives and/or policies. 
• Participate in the Washington State Pharmacy and Therapeutics Committee process. 

Clinical Program Development, Implementation, and Oversight

• Direct and guide the preparation of short and long-range program strategies and plans for the section. 
• Mentor, develop, and coach direct reports to achieve performance standards and development objectives. 
• Provides clinical consultation to the Medicaid and CHIP Director on policy and program strategies that improve the health and well-being of Apple Health recipients. 

Minimum Qualifications

Required qualifications:

Qualifying candidates will satisfy all of the following criteria:

• Medical degree (MD or DO).
• Licensed to practice medicine in the State of Washington. Licensure must be unrestricted. 
• Board certification. 
• Five years of clinical experience. 
• Four years of high-level administrative experience as a medical officer. Can be obtained concurrently. 

Required competencies:

• The ability to take action to learn and grow.
• The ability to take action to meet the needs of others.

Preferred qualifications:

• Board certification in primary care specialty. 
• Four years of high-level administrative experience as a medical officer, preferably in a managed care organization, ideally working with state-sponsored products. 
• Additional business and/or public health-related degrees or training. 
• Experience with:
  • community or migrant health,
  • health equity initiatives, 
  • social determinants of health, 
  • provider engagement, 
  • patient-centered care models, and/or 
  • value-based purchasing.

How to apply:

Only candidates who reflect the minimum qualifications on their NEOGOV profile will be considered. Failure to follow the application instructions below may lead to disqualification. To apply for this position, you will need to complete your profile which includes three professional references and attach in separate files:

• A cover letter that specifically addresses how you meet the qualifications for this position
• Current resume 

To take advantage of veteran preference, please do the following:

• Attach a copy of your DD214 (Member 4 long-form copy), NGB 22, or USDVA signed verification of service letter. 
• Please black out any PII (personally identifiable information) data such as social security numbers. Include your name as it appears on your application in careers.wa.gov. 

Other Qualifications

About HCA: 

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

What we have to offer:

• Meaningful work with friendly co-workers who care about those we serve Voices of HCA
• A clear agency mission that drives our work and is person-centered HCA's Mission, Vision & Values
• A healthy work/life balance, including alternative/flexible schedules and mobile work options.
• A great total compensation and benefit package WA State Government Benefits
• A safe, pleasant workplace in a convenient location with restaurants, and shopping nearby. 
• And free parking!

Notes:

Prior to a new hire, a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment.

HCA is an equal opportunity employer. We value the importance of creating an environment in which all employees can feel respected, included, and empowered to bring unique ideas to the agency. HCA has five employee resource groups (ERGs). ERGs are voluntary, employee-led groups whose aim is to foster a diverse, inclusive workplace aligned with HCA’s mission. Our diversity and inclusion efforts include embracing different cultures, backgrounds and viewpoints while fostering growth and advancement in the workplace. Studies have shown women, racial and ethnic minorities, and persons of disability are less likely to apply for jobs unless they feel they meet every qualification as described in a job description. Persons over 40 years of age, disabled and Vietnam era veterans, as well as people of all sexual orientations and gender identities are also encouraged to apply. If you have any questions about the required qualifications or how your experience relates to them, please contact us at [email protected]. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Jake Nelko at 360-725-0945 or [email protected].

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.

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Benefits

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

Supplemental Questions

Required Question

Agency Information

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View Job Posting for Location, Washington, 98504 Website http://www.careers.wa.gov