This position is in MassHealth's Accountable Care and Behavioral Health Unit, on the Policy Team. The Accountable Care and Behavioral Health Unit manages a variety of programs including the ACO program, Community Partners program, Flexible Services program, and Statewide Investments programs.

This data-focused role will be a core member of the Accountable Care and Behavioral Health Policy team focused on payment operations, technical design and implementation of the primary care sub-capitation program. This person will support a variety of workstreams in collaboration with teams throughout Accountable Care and Behavioral Health and MassHealth broadly, including but not limited to, A) refining payment operations and policy of the primary care sub-capitation program; B) supporting data analysis to ensure compliance to payment and member assignment reporting requirements; and C) coordinating improvements to current reporting procedures related to payment and member assignment to providers, including working with internal teams and external stakeholders (e.g., ACOs and health plans). In addition to their role supporting the primary care sub-capitation program, this person may also support broader ACO policy development workstreams within Accountable Care and Behavioral Health as a member of the Policy Team.

The Program Manager for Primary Care Strategy & Data will be expected to support multiple efforts in a fast-paced, cross-functional work environment, and coordinate workstreams across multiple teams throughout Accountable Care and Behavioral Health and MassHealth.

Background on MassHealth Payment and Care Delivery Reform: MassHealth is Massachusetts's Medicaid and Children's Health Insurance Program (CHIP), providing comprehensive health insurance to over 2 million residents. Our mission is to improve the health outcomes of our diverse members and their families by providing access to integrated health care services that sustainably and equitably promote health, well-being, independence, and quality of life. MassHealth is a national leader in health coverage, policy, and equity, pioneering innovations in payment design, behavioral health, social determinants of health, and access.

MassHealth is currently implementing a multi-year payment and care delivery reform, aiming to improve care for members and the sustainability of the program. The centerpiece of this reform was the roll-out of Accountable Care Organizations, which launched in March 2018, and have since enrolled over 1 million members, or >80% of MassHealth's managed-care eligible members. These payment models are transitioning a significant portion of MassHealth's business from largely unmanaged, fee-for-service care towards a model where providers are accountable for managing population health, quality of care, and integration of services with financial accountability for the total cost of care. Early results of delivery reform efforts have demonstrated improvements in patient outcomes and signs that cost growth is declining.

In the second iteration of the program, which launched in April 2023, all primary care providers participating in ACOs have transitioned to capitation payments - a primary care "sub-capitation" - thereby aligning incentives for primary care providers to focus on the value of services provided, shifting away from volume-based incentives. MassHealth's payment reform efforts are helping to catalyze care delivery reforms at the provider level by enabling primary care providers to deliver "the right care, at the right time, at the right place," including focusing on team-based, integrated primary care services not properly compensated in the current fee-for-service model, integrated behavioral health services, and services addressing health-related social needs. Payment and care delivery reform initiatives such as this primary care sub-capitation program are a key policy goal in Massachusetts, and nationally, where the Centers for Medicare and Medicaid Services (CMS) have articulated a bold vision to improve care for Medicaid beneficiaries nationally. Efforts underway in Massachusetts are at the leading edge of these national policy goals and will impact not only thousands of individual providers in Massachusetts, and over one million MassHealth members, but policy goals and the potential future development of similar programs nationally.

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

• Supporting the ongoing development of the primary care sub-capitation policy and technical design, including:
• Tackling complex analytical and operational questions in a structured and hypothesis-driven manner, identifying options, and laying out recommendations for Accountable Care and Behavioral Health and MassHealth Executive leadership.
• Project managing, joint problem-solving, including leading meetings, producing meeting materials, developing work plans to implement proposed solutions, and conducting follow-up throughout the decision-making process.
• Supporting MassHealth's implementation of the primary care sub-capitation program, including:
• Becoming an internal subject matter expert on ACO models, payment operations, and the primary care sub-capitation model design.
• Working directly and comfortably in a matrixed environment with personnel throughout the agency to serve as a resource and authority on primary care sub-capitation.
• Collaborating closely with other members of Accountable Care and Behavioral Health as well as other offices throughout the agency on the primary care sub-capitation design and implementation workplans.
• Engaging with ACOs, including health plans and provider organizations, implementing the primary care sub-capitation payment model, and supporting problem-solving as the program matures.
• Working with internal and external teams to improve reporting of member assignments to providers.
• Facilitating and supporting integrated policy development within Accountable Care and Behavioral Health and across MassHealth, including:
• Supporting policy development with other teams throughout the agency in a structured, coordinated, and streamlined manner to ensure cross-agency alignment on programmatic priorities.
• Supporting meeting facilitation, agenda setting, work planning, and project management to ensure policy development meets agency timelines and priorities.
• Working closely with Accountable Care and Behavioral Health leadership to drive forward agency-wide goals in policy development and implementation.
• Supporting external stakeholder engagement efforts, including:
• Producing meeting materials for meetings with external stakeholders, including public hearings, technical assistance to managed care plan staff, and technical advisory groups.
• Taking meeting minutes, collecting direct feedback from stakeholders, and synthesizing takeaways and action items.

Key competencies: Strong data analysis and project management skills, advanced proficiency in Microsoft Excel, experience using data management software, ability to synthesize and present large data sets in a clear and concise manner, experience with financial data and report development, knowledge of healthcare policy and payment methodologies, strong communication skills, structured thinking, ability to work in a cross-functional and matrixed environment, ability to learn quickly, and comfort with basic payment/rates principles.

Preferred qualifications:

• 1-4 years' experience in health care, policy, analytics, and/or project management.
• Basic understanding of contracts and legal documents.
• Excellent analytical and problem-solving skills.
• Excellent MS Word, PowerPoint, and Excel skills .
• Familiarity with relational databases, data visualization software, and/or SQL.
• Excellent organizational skills and attention to detail.
• Ability to parse complicated problems with minimal direction, and clearly communicate findings to a variety of stakeholders (internal and external).
• 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 health care 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 an 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.

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.