The mission of MassHealth is to improve the health outcomes of our diverse members, their families and their communities by providing access to integrated health care services that sustainably promote health, well-being, independence and quality of life.
The MasssHealth Office of Long Term Services and Supports (OLTSS) is responsible for managing a comprehensive system of care for elders and persons with disabilities. OLTSS manages a range of thirteen (13) Fee-For-Service (FFS) programs that includes include Hospice, Home Health (HH), Independent Nursing (IN), Therapies, Durable Medical Equipment, Prosthetics and Orthotics (DMEPOS), Personal Care Attendant, Early Intervention, Adult Foster Care (AFC), Group Adult Foster Care, Adult Day Health, Day Habilitation, Nursing Facilities (NFs), and Chronic-Disease Rehabilitation Hospitals CDRHs).
The Senior Manager, Home Based Programs will work with stakeholders and providers to manage programs for MassHealth members using home health, hospice, therapies, independent nursing and Durable Medical Equipment, Prosthetics and Orthotics (DMEPOS). The incumbent will be responsible for assuring those services are delivered in a high quality, cost effective manner through the development of regulations, policies and rates and mechanisms of payment that assure access and improve quality for all MassHealth members.
Duties and Responsibilities (these duties are a general summary and not all inclusive):
Manage the day-to-day oversight of the Home Health, Hospice, Independent Nursing, Therapy and DMEPOS Programs, including but not limited to:
Ensuring program management and service delivery activities effectively support program based services goals;
Providing team members with comprehensive training;
Ensuring team members are knowledgeable about all program areas; and
Assisting with problem resolution.
Oversee, track and monitor projects and initiatives relative to the above programs.
Manage ongoing regulation and rate development, review, and analysis processes, including but not limited to:
Initiating actions to ensure that programs meet commonly accepted standards of care for the relative programs;
Working with provider stakeholder groups to solicit feedback; and
Assisting program managers to develop policy decision documents and memos.
Advise the Director of FFS Program and Deputy Director of Home Based Programs in policy, program, and implementation strategies.
Liaise with the OLTSS Office of Strategic Initiatives in the ongoing management of the LTSS Third Party Administrator (TPA) contractor.
Knowledge of strategic and operational planning processes related to clinical and business operations.
Knowledge of the principles and practices of budget development, risk adjustment and predictive modeling.
Knowledge of management principles and practices related to clinical, interdisciplinary teams.
Knowledge and experience in LTSS program policy development, analysis and evaluation.
Possess an understanding of the role of data and analysis in driving system change.
Ability to develop and maintain effective working relationships with a range of LTSS and Behavioral Health stakeholders and partners.
Knowledge of the Massachusetts health care industry and market dynamics related to LTSS.
Knowledge of payment reform and care delivery reform strategies, including an understanding of the relationship between payment reforms, delivery system change, quality improvement and customer satisfaction in LTSS.
Skilled in problem solving, consensus building, conflict resolution and team building.
Knowledge of business process improvement and change management theory, principles and practices.
Ability to analyze health and human service legislation and policy.
Ability to interpret policies and procedures in written and verbal responses to requests for information.
Ability to understand, apply and explain pertinent laws, rules, regulations, policies and procedures.
Ability to work independently and collaboratively.
Ability to manage time and set priorities and reach decisions under pressure.
Ability to coordinate and communicate health and human service policy positions.
Ability to regularly and proficiently utilize MS Work, MS Excel, MS PowerPoint, and Visio (or equivalent) to perform daily functions .
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 and click on "Information for Job Applicants".
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.
For questions, please contact the CYF Office of Human Resources at 1-800-510-4122 and select option #2.
MINIMUM ENTRANCE REQUIREMENTS:
Applicants must have at least (A) five (5) 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.
I. A certificate in a relevant or related field may be substituted for one (1) year of the required experience.
II. A Bachelor’s degree in a related field may be substituted for two (2) years of the required experience.
III. A Graduate degree in a related field may be substituted for three (3) years of the required experience.
IV. A Doctorate degree in a related field may be substituted for four (4) years of the required experience.