ForHealth Consulting at UMass Chan Medical School · 13 hours ago
Senior Program Mgr, MassHealth Quality Programs OCA
North Quincy, MA
Full-time
Onsite
Senior Level
5+ years expForHealth Consulting at UMass Chan Medical School is seeking a Senior Program Manager for MassHealth Quality Programs. The role involves leading the development and implementation of quality programs aimed at improving health equity and patient experience for MassHealth members, collaborating with various program teams and stakeholders.
Management Consulting
Responsibilities
Lead, in partnership with MassHealth program teams (including the MassHealth Office of Behavioral Health, the MassHealth Office of Long-Term Services and Supports, and the Office of Provider and Pharmacy Programs), strategy and design of quality programs including for behavioral health providers, Integrated Care Programs, and acute hospitals
Lead, in partnership with MassHealth program teams, programmatic strategy and design including related to:
Selection of quality and health equity measures
Setting of performance targets
Establishing and testing performance assessment methodologies
Maintaining and updating contractual and regulatory documents to accurately reflect quality program design
Together with MassHealth Quality Office leaders, contribute to the development and ongoing maintenance of the MassHealth Quality Strategy
Regularly report to OCA leadership and staff (and other entities, at OCA leadership direction) on the status of MassHealth quality and health equity measurement programs and progress towards quality and health equity priorities
Lead, in partnership with MassHealth program teams, implementation of MassHealth quality and health equity measurement programs including for behavioral health providers, long-term services and supports including those delivered through Integrated Care Programs, and acute hospitals
Monitor and analyze quality and health equity measurement program performance
Lead performance remediation processes, as applicable
Monitor, analyze, and report on quality and health equity measure performance
Lead and/or support program teams in developing and implementing quality and health equity performance management activities
Manage necessary quality analytics resources to support MassHealth quality and health equity program functions, including by coordinating and overseeing inputs from OCA and MassHealth data and analytics staff
Lead stakeholder engagement and education activities with external stakeholders (providers, health system representatives, federal authorities including CMS) through activities such as leading regular office hours, maintaining stakeholder requests, and through other venues as assigned
Manage negotiations with CMS, as needed, to support continued authority for quality and health equity measurement programs
Lead and/or support relevant MassHealth program advisory groups, including by preparing materials, managing activities, and being accountable for necessary follow-up activities
Engage with contracted vendors, as appropriate, on MassHealth quality and health equity measurement program-specific deliverables
Serve as a subject matter expert for MassHealth quality and health equity measurement programs
Contribute to design and implementation of cross-cutting quality initiatives that impact multiple programs within MassHealth, including related to health equity and member experience
Hire, advise and directly supervise and evaluate performance of other staff
Provide functional supervision of other specific project/program staff as needed
Review and monitor compliance with the federal and state regulations
Perform other duties as required
Qualification
Required
Master's Level Degree in Health Care or Business Administration, Public Health, or a quality related health care field
5 – 7 years of experience leading health care quality measurement and performance programs
Experience with acute hospital quality measurement
Experience with behavioral health quality measurement and/or long-term-services or supports quality measurement
Experience in a recent management/supervisory role
Excellent communication and presentation skills, both oral and written, to interact with leadership, staff, providers and other stakeholders
Preferred
Experience with quality measurement in ambulatory and inpatient settings
Experience with Medicaid quality measurement programs
Experience with health equity measurement
Experience with quality measure development
Quality analytics experience, including use of Medicaid claims data
Flexibility and ability to thrive in a fast-paced, dynamic environment
Company
ForHealth Consulting at UMass Chan Medical School
ForHealth Consulting partners with purposeful organizations, including state Medicaid agencies and health and human services organizations, to make the healthcare experience better for all – more equitable, effective, and accessible.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Carly Gould
Senior Human Resources Business Partner
Jatin Dave
Chief Medical Officer, MassHealth
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