Job Description
The MassHealth 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 Agency (HHA), Independent Nursing (IN), Therapies, DMEPOS programs (Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment, Prosthetics and Orthotics), Personal Care Attendant (PCA), Early Intervention, Adult Foster Care (AFC), Group Adult Foster Care (GAFC), Adult Day Health (ADH), Day Habilitation, Nursing Facilities, Chronic-Disease Rehabilitation Hospitals as well as two coordinated care programs, Senior Care Options (SCO) and the Program of All Inclusive Care for the Elderly (PACE).
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The Personal Care Attendant (PCA) Program Manager manages the contracts for two types of providers: 1 Fiscal Intermediary (FI) and 18 Personal Care Management (PCM) agencies. This work includes Compliance Management, Contract Management, and functioning as Team Lead for the OLTSS PCA Team.
Duties and Responsibilities (these duties are a general summary and not all inclusive):
- Develop and implement procedures and guidelines to accomplish program objectives and goals.
- Design and conduct analyses of current and proposed payment methods and policies for PCA program.
- Utilize the OLTSS finance dashboard and other available reporting to analyze program performance and to support rate development and fiscal impacts.
- Ensure program management and service delivery activities effectively support program services goals.
- Assist in the orientation and training of new program staff.
- Manage and provide ongoing support and guidance to team members.
- Manage projects and initiatives relative to the programs.
- Oversee TPA in program-related Board of Hearing (BOH) cases and collaborate with appropriate OLTSS internal staff.
- Manage the review, filing, and follow up of critical incident reports.
- Manage multiple priority projects and maintain up-to-date work plans, implementation strategies and communication plans.
- Draft procurement materials, communications, and reporting metrics.
- Establish and maintain stakeholder relationships.
- Oversee the PCM and FI contract compliance and any necessary update or amendment to those contracts.
- Work cross-functionally within MassHealth and with other state agencies.
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:
- Knowledge of strategic and operational planning processes related to clinical and business operations.
- Experience leading a team of professionals.
- Knowledge and experience in LTSS program policy development, analysis and evaluation.
- Possess strong programmatic knowledge of the PCA program.
- Possess an understanding of the role of data and analysis in driving system change.
- Knowledge of the Massachusetts health care industry and market dynamics related to LTSS.
- Proficiency in Microsoft Excel, Word, and PowerPoint; knowledge of Microsoft Project and Visio is a plus.
- 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.
- Ability to understand, apply and explain pertinent laws, rules, regulations, policies and procedures.
- Knowledge of the methods used in the preparation of charts, graphs and tables, and of the methods of general report writing.
- Ability to analyze and determine the applicability of data, to draw conclusions and to make appropriate recommendations.
- Skilled in problem solving, consensus building, conflict resolution and team building.
- Ability to interpret policies and procedures in written and verbal responses to requests for information.
- Ability to work independently and collaboratively.
- Ability to manage time and set priorities and reach decisions under pressure.
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 and tax history 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 Reasonable Accommodation Online Request Form..
For questions, please contact the Office of 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) 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.
Substitutions:
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.
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.