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MassHealth ‘s Office of Long Term Services and Supports (OLTSS) is seeking qualified applicants for the position ofProgram Manager, Adult Day Health and Day Habilitation Programs. The Program Manager, Adult Day Health and Day Habilitation Programs oversees the contracts for two types of providers: Adult Day Health (ADH) and Day Habilitation Providers (DH). This work includes Compliance Management, Contract Management, and functioning as contact and lead for the OLTSS ADH/DH workstream. _Duties and Responsibilities (these duties are a general summary and not all inclusive)_: * Collaborate with the ADH/DH team in managing day to day interaction with the OLTSS Third Party Administrator (TPA) related to the execution of their functions relating to provider enrollment and credentialing, claims operations, prior authorization, appeals, program integrity and reporting related to the ADH/DH programs, and appropriately escalating issues to the Senior Manager/Director/DeputyDirector of Community Programs. * Respond to interagency inquiries and requests for information regarding payment and policy. * Collaborate with the OLTSS External Affairs team to resolve program policy and service delivery issues and to respond to legislative and constituent requests and on drafting of talking points, policies, and meeting materials. * Coordinate with budget, legal, providers, other state agencies and advocacy groups to appropriately implement program and ensure access and quality of care. * Manage ADH/DH Program staff in drafting materials for members, providers, oversee coordination with OLTSS leadership, MassHealth administration, budget, finance, legal, Claims Operations, Board of Hearings, MassHealth. * Publications, Stakeholders and other state agencies in the development and dissemination of those materials. * Update existing program regulations and sub-regulatory guidance (bulletins and other communication) and billing instructions as needed. * Assist other units within the OLTSS, the Executive Office of Elder Affairs, and sister agencies in the state government with information and coordination pertaining to the ADH/DH programs. * Participate in the multi-disciplinary budget planning team consisting of EOHHS budget staff and Center for Health Information Analysis (CHIA) staff. * Lead all stakeholder engagement related to the ADH/DH programs including development and maintenance of effective working relationships with a range of internal and external stakeholders and provide timely communication. * Lead in the development and implementation of provider training. * Oversee provider compliance with all applicable program rules, regulations and sub-regulatory guidance including provider education, engagement and escalation including referral for audit and implementation and management of corrective action plans. * Effectively communicate priority project statuses, risks and outstanding decisions to OLTSS and MassHealth leadership both verbally and in written form under quick timelines including the active and ongoing use of OLTSS project management and tracking tools. * Provide program-related assistance to other units within MassHealth, the Executive Office of Elder Affairs, and other agencies in the state government. * Conduct onsite visits with providers including but not limited to program audits, site reviews and provider education visits (limited travel required). _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 ADH/DH programs. * 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 the 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. 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. Job: Administrative Services* *Organization: Exec Office Of Health and Human Services *Title: *Program Manager Adult Day Health and Day Habilitation Location: Massachusetts-Boston-1 Ashburton Place Requisition ID: 2400070V