ACOs are the central managed care delivery system of MassHealth's current 1115 Demonstration, which has been a critical tool in enabling Massachusetts to achieve and maintain near-universal health coverage, sustain the Commonwealth's safety net health system, expand critical behavioral health services, and implement reforms in the way that care is delivered. MassHealth ACOs initially launched in 2018 and 17 new ACOs were launched in 2023. ACOs are provider-led managed care organizations accountable for improving quality of care, member experience, and total cost of care. Since 2018, ACOs have transitioned care for over a million members from a largely fee-for-service system towards a value-based payment model where providers are accountable for managing the health of their membership.

The Health Plan Administration Contracts Manager will drive towards improved healthcare outcomes for members, robust and high-quality service delivery and streamlined administrative processes by managing relationships and key contact functions with a set of health plans and vendors. The incumbent will ensure the contract compliance of assigned accounts, including the management of audits, response to Centers for Medicare and Medicaid Services (CMS) questions and coordinating with various subject matter expert (SME) teams on the review and approval of submitted reports and other deliverables, supporting various MassHealth workstreams related to the management of the ACO program. The incumbent will work alongside other health plan contract managers and staff from across other offices in MassHealth, such as Enrollment Operations, the Office of Long Term Services and Supports (OLTSS), the Pharmacy Office, etc. to gather information about current initiatives and present findings to ACBH and MassHealth Leadership.

The Health Plan Administration Contract Manager will be expected to support multiple efforts in a fast-paced, cross-functional work environment, and coordinate workstreams across multiple teams throughout ACBH and the agency. They will need to be attentive to detail and have excellent communication skills.

Duties and Responsibilities (these duties are a general summary and not all inclusive):

• Manage relationships and key contacts with a set of health plans and vendors, including providing front-line operational support, and customer service for assigned accounts.
• Ensure the contract compliance of assigned accounts, including handling audits and CMS questions and coordinating with various subject matter expert teams on the review and approval of submitted reports.
• Support various MassHealth workstreams related to the management of the ACO programs, including care delivery-related performance management and cross-functional operational improvements.
• Respond to urgent policy or design priorities or ad hoc requests for policy analysis or document review for the ACO program, as identified.

Required Qualifications:

• Ability to set goals and strive for excellence or improvement.
• Ability to identify a problem or opportunity and take action to address current or future problems and opportunities.
• Ability to think through problems, organize information, and identify key factors and underlying causes to generate solutions.
• Ability to work cooperatively with others and be part of a team.

Preferred Qualifications:

• Excellent analytical and problem-solving skills.
• Excellent communication skills.
• Excellent skills utilizing the Microsoft Office Suite, especially Word, Excel and PowerPoint
• Excellent facility with ACO and MCO program content.
• Comfort with multitasking.
• Comfort with working under high pressure and tight time constraints.
• Ability to take ownership of workstreams with high-level direction and guidance.
• Ability to provide structure and process management to the projects.
• Strong interpersonal skills.
• Passion for public service.
• Excellent performance in multitasking complex projects.
• Experience working in analytical capacity.
• Demonstrated ability to collaborate successfully across diverse teams.
• Background in healthcare management or policy, preferred.

TO APPLY:

Please upload both Resume and Cover Letter for this position when applying. First consideration will be given to those applicants that apply within the first 14 days.

About MassHealth:

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.

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 an ADA accommodation, please click on the link and complete the

ADA Reasonable Accommodation Request Form.

For questions, please the contact the Executive Office of Health and Human Services Human Resources at 1-800-510-4122 and select option #4.

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.

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.