Program Manager, Integrated Policy and Contracting
Apply NowCompany: Masse
Location: Boston, MA 02115
Description:
This Program Manager for Policy and Contracts on the Accountable Care and Behavioral Health (ACBH) Accountable Care and Policy Innovation Team will play a leading role in driving forward MassHealth policy, compliance, and operations for the ACO and MCO programs and support policy development and program operations with other teams throughout MassHealth. This role will support contract development and oversight, updating regulations, stakeholder engagement, and project management, in a fast-paced, cross-functional, and matrixed work environment to improve services for MassHealth members. This role will also support broader MassHealth managed care policy development as a member of the Accountable Care Innovations & Policy Team in the Office of Accountable Care and Behavioral Health.
This role will be in the Accountable Care and Policy Innovation Team in the agency's Office of Accountable Care and Behavioral Health (ACBH). ACBH oversees MassHealth's managed care plans, behavioral health care, and many of the agency's 1115 demonstration initiatives, including the ACO program and Community Partners program. The Program Manager for Policy and Contracts will be a core member of the policy team helping to refine policy and operations of the ACO and MCO programs, and to develop the contract language and frameworks to implement that policy, supporting multiple workstreams including, but not limited to, (1) working with program management and implementation teams to track required contractual and regulatory updates (2) identifying areas of program design that would benefit from additional policy detail to support clearer communication and better management of ACO/MCOs, and working within ACBH and with other offices throughout MassHealth to develop and advance such policy; (3) collaboratively supporting the development of integrated and well-coordinated programs, including ensuring that new proposals fit coherently with existing needs and structures; (4) supporting new and refined policy into ACO and MCO contracts, including overseeing contract development, amendments, and processing within ACBH and through close collaboration with the Legal department; (5) working with teams throughout MassHealth to translate new policies and program details into contract language to be effectuated through new managed care contract language; and, (6) engaging in ad hoc or program-related issue resolution at the direction of MassHealth leadership.
Duties and Responsibilities (these duties are a general summary and not comprehensive):
o Tackling complex policy questions in a structured and hypothesis-driven manner, identifying options and laying out recommendations for ACBH and MassHealth Executive leadership
o Project managing joint problem-solving, including leading meetings, producing meeting materials, and conducting follow-up throughout the decision-making process
o Becoming an internal subject matter expert on the ACO models
o Collaborating closely with other members of ACBH as well as other offices throughout the agency on the ACO model design and implementation workplans
o Supporting management of ACO and MCO contracts and contract updates and policy requirement documents, including managed care bulletins
o Coordinating between MassHealth teams to ensure policy changes and new programmatic details are properly processed and codified in ACO and MCO contracts
o Collaborating closely with MassHealth legal team in managing, updating, and reviewing managed care contracts
o Supporting communication with other states and federal agencies on managed care contracts
o Serving as an internal subject matter expert on contractual implications for policy development
o Answering questions from the Centers for Medicare and Medicaid (CMS) regarding the ACO and MCO contracts
o Drafting and coordinating federally required documentation, such as Directed Payment pre-prints
o Tracking and implementing updates to ACO and MCO contracts based on CMS feedback
o Ensuring MassHealth regulations regarding managed care adhere to federal standards
o Working directly and comfortably with teams within ACBH and across the agency to identify new areas for policy development to improve services for MassHealth members
o Supporting meeting facilitation, agenda setting, work planning, and project management to ensure policy development meets agency timelines and priorities
o Working closely with ACBH leadership to drive forward agency-wide goals in policy development and implementation
Preferred qualifications :
About MassHealth
To improve the health outcomes of our diverse members and their families by providing access to integrated healthcare services that promote sustainable & equitable health, well-being, independence and quality of life.
For more information about our agency and programs please visit: www.mass.gov/masshealth
Pre-Offer Process :
A criminal background check will be completed on the recommended candidate as required by the regulations set forth by the Executive Office of Health and Human Services prior to the candidate being hired. For more information, please visit http://www.mass.gov/hhs/cori
Education, licensure and certifications will be verified in accordance with the Human Resources Division's Hiring Guidelines.
Education and license/certification information provided by the selected candidate(s) is subject to the Massachusetts Public Records Law and may be published on the Commonwealth's website.
If you require assistance with the application/interview process and would like to request ADA accommodation, please click on the link and complete the ADA Reasonable Accommodation Request Form
For questions regarding this requisition, please contact the Executive Office of Health and Human Services Human Resources at 1-800-510-4122 and select option 4.
TO APPLY :
Please upload both Resume and Cover Letter for this position when applying.
Qualifications:
MINIMUM ENTRANCE REQUIREMENTS:
Applicants must have at least (A) four (4) years of full-time or, equivalent part-time, professional, professional internship, administrative, supervisory, or managerial experience in business administration, business management, public administration, public management, clinical administration or clinical management or (B) any equivalent combination of the required experience and substitutions below.
Substitutions:
I. A certificate in a relevant or related field may be substituted for one (1) year of the required experience.
II. An Associate's degree in a related field may be substituted for one (1) year of the required experience.
III. A Bachelor's degree in a related field may be substituted for two (2) years of the required experience.
IV. A Graduate degree in a related field may be substituted for three (3) years of the required experience.
V. A Doctorate degree in a related field may be substituted for the required experience.
*** Salary placement is determined by a combination of factors, including the candidate's years of directly related experience and education, and alignment with our internal compensation structure as set forth by the Human Resources Division's Hiring Guidelines. For all bargaining unit positions (non-management), compensation is subject to the salary provisions outlined in the applicable collective bargaining agreement and will apply to placement within the appropriate salary range.
Comprehensive Benefits
When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.
Want the specifics? Explore our Employee Benefits and Rewards!
An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.
The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.
This role will be in the Accountable Care and Policy Innovation Team in the agency's Office of Accountable Care and Behavioral Health (ACBH). ACBH oversees MassHealth's managed care plans, behavioral health care, and many of the agency's 1115 demonstration initiatives, including the ACO program and Community Partners program. The Program Manager for Policy and Contracts will be a core member of the policy team helping to refine policy and operations of the ACO and MCO programs, and to develop the contract language and frameworks to implement that policy, supporting multiple workstreams including, but not limited to, (1) working with program management and implementation teams to track required contractual and regulatory updates (2) identifying areas of program design that would benefit from additional policy detail to support clearer communication and better management of ACO/MCOs, and working within ACBH and with other offices throughout MassHealth to develop and advance such policy; (3) collaboratively supporting the development of integrated and well-coordinated programs, including ensuring that new proposals fit coherently with existing needs and structures; (4) supporting new and refined policy into ACO and MCO contracts, including overseeing contract development, amendments, and processing within ACBH and through close collaboration with the Legal department; (5) working with teams throughout MassHealth to translate new policies and program details into contract language to be effectuated through new managed care contract language; and, (6) engaging in ad hoc or program-related issue resolution at the direction of MassHealth leadership.
Duties and Responsibilities (these duties are a general summary and not comprehensive):
- Supporting the ongoing revision of the ACO and MCO models detailed technical design, including:
o Tackling complex policy questions in a structured and hypothesis-driven manner, identifying options and laying out recommendations for ACBH and MassHealth Executive leadership
o Project managing joint problem-solving, including leading meetings, producing meeting materials, and conducting follow-up throughout the decision-making process
- Supporting the ACO models' implementation, including:
o Becoming an internal subject matter expert on the ACO models
- Working directly and comfortably in a matrix environment with personnel throughout the agency to serve as a resource and authority on ACO model design
o Collaborating closely with other members of ACBH as well as other offices throughout the agency on the ACO model design and implementation workplans
- Supporting management of MassHealth's ACO and MCO contracts, including:
o Supporting management of ACO and MCO contracts and contract updates and policy requirement documents, including managed care bulletins
o Coordinating between MassHealth teams to ensure policy changes and new programmatic details are properly processed and codified in ACO and MCO contracts
o Collaborating closely with MassHealth legal team in managing, updating, and reviewing managed care contracts
- Supporting MassHealth legal team in ensuring all ACO and MCO contracts meet appropriate requirements
o Supporting communication with other states and federal agencies on managed care contracts
o Serving as an internal subject matter expert on contractual implications for policy development
- Supporting compliance with federal law and regulation, including:
o Answering questions from the Centers for Medicare and Medicaid (CMS) regarding the ACO and MCO contracts
o Drafting and coordinating federally required documentation, such as Directed Payment pre-prints
o Tracking and implementing updates to ACO and MCO contracts based on CMS feedback
o Ensuring MassHealth regulations regarding managed care adhere to federal standards
- Supporting contractual policy integration, including:
o Working directly and comfortably with teams within ACBH and across the agency to identify new areas for policy development to improve services for MassHealth members
o Supporting meeting facilitation, agenda setting, work planning, and project management to ensure policy development meets agency timelines and priorities
o Working closely with ACBH leadership to drive forward agency-wide goals in policy development and implementation
Preferred qualifications :
- Experience in healthcare management, healthcare finance, or health policy preferred.
- 1-3 years' experience in health care, policy, and/or project management.
- Basic understanding of contracts and legal documents. Paralegal experience is an asset.
- Highly organized and detail oriented.
- Excellent analytical and problem-solving skills.
- Excellent MS Word and PowerPoint skills.
- Ability to lead projects through organizing work, establishing operating relationships, and coordinating the work of others.
- Strong communication skills.
- Strong interpersonal skills.
- Passion for public service.
- Enjoy working infast paced environment, often including tight time constraints.
About MassHealth
To improve the health outcomes of our diverse members and their families by providing access to integrated healthcare services that promote sustainable & equitable health, well-being, independence and quality of life.
For more information about our agency and programs please visit: www.mass.gov/masshealth
Pre-Offer Process :
A criminal background check will be completed on the recommended candidate as required by the regulations set forth by the Executive Office of Health and Human Services prior to the candidate being hired. For more information, please visit http://www.mass.gov/hhs/cori
Education, licensure and certifications will be verified in accordance with the Human Resources Division's Hiring Guidelines.
Education and license/certification information provided by the selected candidate(s) is subject to the Massachusetts Public Records Law and may be published on the Commonwealth's website.
If you require assistance with the application/interview process and would like to request ADA accommodation, please click on the link and complete the ADA Reasonable Accommodation Request Form
For questions regarding this requisition, please contact the Executive Office of Health and Human Services Human Resources at 1-800-510-4122 and select option 4.
TO APPLY :
Please upload both Resume and Cover Letter for this position when applying.
Qualifications:
MINIMUM ENTRANCE REQUIREMENTS:
Applicants must have at least (A) four (4) years of full-time or, equivalent part-time, professional, professional internship, administrative, supervisory, or managerial experience in business administration, business management, public administration, public management, clinical administration or clinical management or (B) any equivalent combination of the required experience and substitutions below.
Substitutions:
I. A certificate in a relevant or related field may be substituted for one (1) year of the required experience.
II. An Associate's degree in a related field may be substituted for one (1) year of the required experience.
III. A Bachelor's degree in a related field may be substituted for two (2) years of the required experience.
IV. A Graduate degree in a related field may be substituted for three (3) years of the required experience.
V. A Doctorate degree in a related field may be substituted for the required experience.
*** Salary placement is determined by a combination of factors, including the candidate's years of directly related experience and education, and alignment with our internal compensation structure as set forth by the Human Resources Division's Hiring Guidelines. For all bargaining unit positions (non-management), compensation is subject to the salary provisions outlined in the applicable collective bargaining agreement and will apply to placement within the appropriate salary range.
Comprehensive Benefits
When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.
Want the specifics? Explore our Employee Benefits and Rewards!
An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.
The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.