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Provider Compliance Manager

AT The Commonwealth of Massachusetts
The Commonwealth of Massachusetts

Provider Compliance Manager

Boston, MA

Job Description

The mission of the Department of Developmental Services (DDS) is to create, in partnership with others, innovative and genuine opportunities for individuals with intellectual and developmental disabilities to participate full and meaningfully in, and contribute to, their communities as valued members.

The Provider Compliance Manager (Manager) works in the Department's Office of Quality Management (OQM) under the supervision of the Assistant Commissioner of Quality Management. OQM is specifically dedicated to developing, implementing and refining all aspects of the Department's quality management and improvement system. OQM approaches quality from three perspectives: individual, provider, and system. OQM oversees risk management, human rights, medication administration, health equity, clinical consultations, mortality reviews, and licensure/certification. There are many systems and processes of oversight to address quality at the individual level. Similarly, licensure/certification addresses overall quality at the level of the provider and its systems. The Provider Compliance Manager will be charged with the oversight of the specific settings, locations, and sites of providers, monitoring the ongoing quality of providers at a site level. Specifically, the Manager will use data analytics to identify provider compliance issues and concerns about service provision which presents risks to the health, safety, and welfare of service recipients.

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

The Provider Compliance Manager will oversee the development and implementation of a data analytic system that synthesizes and summarizes incident report data, DPPC allegation and investigation data, restraint reports, medication occurrence reports, information from health care records, and information from DDS field staff at a site and provider level. The Manager will then use this system to identify patterns and trends that may indicate issues and challenges at sites and/or providers. Once identified, the Manager will communicate these patterns and trends with the Areas and Regions impacted. The Manager will coordinate with the Areas and Regions (including the Administrative Review Managers) and other appropriate DDS staff through regularly scheduled meetings. During these meetings, the Manager will guide the staff to determine action plans and next steps to mitigate, improve, or otherwise solve the issues/challenges reported. The Manager will review action plans and next steps for appropriateness and completeness given the issues/challenges reported and will assure that responsible parties are identified and engaged. The Manager will monitor the progress of the action plans and next steps through the regularly scheduled meetings and through documentation.

The Manager will indirectly supervise 4 regional Administrative Review Managers. This will include participation in the hiring, training, and supervision of these staff. The Manager will coordinate the activities of the Regional Administrative Review Managers, providing guidance, training, and oversight of action plan activities which are tasked to them. This will include organizing and facilitating regular statewide meetings of the group of these managers.

The Manager will utilize interns on a regular basis. The Manager will assess OQM needs and make recommendations to engage in the hiring of interns to assist with discrete projects as needed. The Manager will directly supervise these interns. This will include participation in the hiring, training, and supervision of these staff.

The Manager will lead day-to-day efforts to ensure that DDS has the tools and data it needs to conduct monitoring and oversight operations as well as report to DDS and EOHHS senior leadership and other oversight bodies.

The Manager will provide project management in developing, implementing and assessing new data analytic and monitoring processes. The Manager will provide project management and lead planning efforts for the Department in developing and implementing proposals, ensuring alignment with Secretariat priorities.

The Manager will be responsible for working with leadership to support the coordination of all regular provider compliance data analysis, which includes overall tracking the location, provider, area, region, and statewide activities of various reports, and following up on findings and action plans.

The Manager identifies priorities for additional reviews based on analyses and prepares an annual plan for conducting reviews in collaboration with the Assistant Commissioner of Quality Management.

The Manager manages the staffing resource assignments and oversees the completion of follow-up activities.

Preferred Qualifications:

  • Ability to analyze data sets
  • Ability to identify patterns and trends within data sets
  • Ability to analyze and determine the applicability of program data, to draw conclusions and to make appropriate recommendations
  • Knowledge of federal and state laws governing DDS programs and functions.
  • Knowledge of principles and practices of program management, operations, systems, accounting, procurement and contracting as it pertains to DDS
  • Experience in project planning and management
  • Good IT skills
  • Great attention to detail
  • Knowledge of business practice improvement strategies.
  • Ability to work collaboratively within or outside the Department of Developmental Services.
  • Ability to identify a problem or opportunity and take action to address current or future problems and opportunities
  • Ability to work under severe time constraints.
  • Ability to identify success and barriers related to policy implementation.
  • Ability to work effectively with others to resolve policy and/or operational conflicts.
  • Ability to build and/or maintain friendly, reciprocal, professional relationships and networks of contacts
  • In-depth and applied administrative, accounting, investigative, auditing and business operations experience with an emphasis on planning, public administration, systems and regulatory and contract compliance
  • A capacity to utilize the department's various information systems to obtain and analyze data
  • Excellent organization and communication skills
  • An interest in supporting human services agencies to provide effective services in a fiscally prudent manner

Education, licensure, and certifications will be verified in accordance with the Human Resources Division's Hiring Guidelines.

Education and license/certification information provided the selected candidate(s) is subject to the Massachusetts Public Records law and may be published on the Commonwealth's website.

Pre-Hire Process:

Recommended candidates must successfully complete pre-employment screening which includes:

  • Disabled Persons Protection Commission (DPPC) Abuse Registry Search:

https://www.mass.gov/info-details/dppc-abuser-registry

  • Criminal background check (CORI) by regulations set forth by the Executive Office of Health and Human Services.

http://www.mass.gov/hhs/cori

  • National Background Checks, Chapter 234 of the Acts of 2014, conduct fingerprint-based check.

https://www.mass.gov/lists/dds-fingerprint-background-checks

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 Reasonable Accommodation Online Request Form

For technical help with MassCareers, including logging into your profile and/or resetting your password, please call the Employee Service Center at 617-979-8500 for assistance.

For questions regarding this requisition, please contact the Executive Office of Health and Human Services Human Resources at 1-800- 510-4122 Ext. #4.

Qualifications

MINIMUM ENTRANCE REQUIREMENTS:

Applicants must have at least (A) five (5) years of full-time or, equivalent part-time, professional, administrative, supervisory, or managerial experience in business administration, business management, public administration, public management, clinical administration or clinical management of which (B) at least one (1) year must have been in a project management, supervisory or managerial capacity or (C) 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 (A) experience.

II. A Bachelor's degree in a related field may be substituted for two (2) years of the required (A) experience.

III. A Graduate degree in a related field may be substituted for three (3) years of the required (A) experience.

IV. A Doctorate degree in a related field may be substituted for four (4) years of the required (A) 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.

Client-provided location(s): Boston, MA, USA
Job ID: Commonwealth_of_Massachusetts-240009Z4
Employment Type: Full Time

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Health Reimbursement Account
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • Short-Term Disability
    • Long-Term Disability
    • FSA
    • HSA
    • Mental Health Benefits
  • Parental Benefits

    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Hybrid Work Opportunities
  • Office Life and Perks

    • Commuter Benefits Program
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
    • Volunteer Time Off
  • Financial and Retirement

    • Pension
    • Financial Counseling
  • Professional Development

    • Promote From Within
    • Mentor Program
    • Access to Online Courses
    • Lunch and Learns
    • Internship Program
    • Leadership Training Program
    • Associate or Rotational Training Program
  • Diversity and Inclusion

    • Diversity, Equity, and Inclusion Program