Job Description

Position Purpose:

The Manager, Medicaid ACO Program Operations manages key programmatic components and initiatives of the Medicaid ACO program, and provides support to assist in achieving Medicaid program goals.

Key Responsibilities:

  • Develop, monitor, and maintain in-depth knowledge of Medicaid program rules and requirements, and translate those rules and requirements into business and operational execution
  • Provide oversight of key operational functions for the Medicaid ACO, including member enrollment, provider enrollment, member services, information systems, and compliance. Collaborate with these cross-functional stakeholders to implement new requirements and enhancements necessary to ensure optimal program performance and compliance.
  • Serve as key internal point of contact for issue escalations and resolutions from members and providers. Work with regulators as needed to solve problems as they occur.
  • Staff the Operations Committee of the Steward Medicaid ACO. Prepare agendas and materials for committee meetings, and coordinate development and submission of regulatory documentation.
  • Manage vendors for program initiatives, including contract compliance, budget, and performance against initiative goals.
  • Interface with regulators to participate in and report back on MassHealth program meetings, track and obtain responses on program questions, etc.
  • Other duties related to Medicaid program as assigned.

Education / Experience / Other Requirements

Education:

  • Bachelor’s degree required. Masters preferred

Years of Experience:

  • Three or more years health care experience

Specialized Knowledge:

  • Experience managing programs, initiatives, projects.
  • Experience working in a fast-paced environment
  • Analytic skills to collect information from diverse sources and summarize the information and data to solve problems.
  • Accuracy and attention to detail required
  • Demonstrates ability to think critically and creatively
  • Possesses specialized knowledge related to Medicaid
  • Possesses strong interpersonal written and oral skills
  • Possesses excellent time management skills with proven ability to effectively manage multiple tasks and priorities at one time.
  • Ability to create, interpret, and disseminate information across multiple internal and external stakeholders
  • Possesses strong project management techniques to take initiatives from idea to execution
  • Ability to work as part of a team and collaborate with colleagues across departments in a highly matrixed environment
  • Accepts flexibility in work schedule willingly. (e.g. periodic early morning or evening meetings)
  • Requisite poise, judgment, and trustworthiness to represent Steward to internal and external groups
  • Ability to adapt and respond to changes in environment and priorities
  • Strong knowledge of standard computer software tools, including Microsoft Word, Excel, PowerPoint, Outlook; Visio, Project, and SharePoint.

Application Instructions

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