The Health Safety Net Office resides within the Office of Medicaid (or MassHealth) under the Executive Office of Health and Human Service. The Director of Safety Net Programs oversees the Health Safety Net (HSN) as well as the MassHealth Limited and Children's Medical Security Programs (CMSP). HSN, MassHealth Limited, and CMSP are a core part of MassHealth and provide reimbursement to eligible providers servicing eligible recipients. MassHealth is seeking qualified applicants for theHealth Safety Net Policy Manager position. The Policy Manager of the Health Safety Net Office shall be responsible for oversight of the policy unit of the Health Safety Net Office. The incumbent is responsible for the development, implementation, and coordination of Health Safety Net eligibility and payment policy, ensuring that the Health Safety Net is aligned with MassHealth and Connector policies, as well as the Commonwealth's overall health care reform goals, as appropriate. Duties and Responsibilities (these duties are a general summary and not all inclusive): Responsible for the development, implementation, and coordination of Health Safety Net eligibility policy and ensuring that the Health Safety Net is aligned with MassHealth and Connector policies as well as the Commonwealth's overall health care reform goals as appropriate. Develop and implement Health Safety Net payment policy in coordination with Exec staff, legal staff, finance staff, IT, MMIS and operations. Provide policy direction to HSN operations and contractors. Manage the investigation and resolution of HSN claims processing issues, including coordination of staff and contractor resources and communication with providers. Oversee annual code updates, participate in MassHealth update process to ensure alignment between MassHealth and HSN. Oversee the development and implementation of payment rates for providers. Oversee the development and editing of annual reports to the legislature on eligibility requirements, provider reimbursement levels, and recommendations for ongoing improvements. Manage contracts with select outside vendors. Participate in or coordinate and facilitate meetings with internal and/or external stakeholders as necessary. Support the transition of HSN claims adjudication to MMIS, including facilitating testing and the development of test cases, liaising with the MMIS team, and end user training and communication. Supervise and mentor HSN Policy staff, including policy analysts and a data analyst. Support initiatives to reform HSN policy to improve the sustainability of the HSN in future years, including implementing updates to HSN regulations, managing the pulling of data to support policy decision making, and preparing recommendations and briefing materials for presentation to executive leadership. Oversee the establishment of standard operating procedures for regular HSN yearly deliverables. Other duties as assigned. Preferred Qualifications: A broad knowledge of health care payment systems, health care delivery systems and health care coverage options available under Chapter 58. Ability to communicate effectively. Demonstrated quantitative and qualitative policy analysis skills. Project management experience. Ability to solve problems. Ability to manage multiple projects simultaneously and to respond to changes in priorities in a flexible manner. Ability to plan, prioritize and delegate tasks, and to utilize staff members to accomplish assigned work objectives. 3-5 years of full time, or equivalent part-time, analyst or supervisory experience in health care, payment and policy environment. TO APPLY: Please upload both Resume and Cover Letter for this position when applying. First consideration will be given to those applicants that apply within the first 14 days. About MassHealth: MassHealth is the Commonwealth's Medicaid and Children's Health Insurance Program, providing comprehensive healthcare coverage and services to approximately two million Massachusetts residents. Through partnerships with providers, health plans, community organizations, and government agencies, MassHealth works to improve health outcomes, reduce disparities, strengthen care coordination, and ensure access to high-quality, person-centered care. As one of the largest Medicaid programs in the country, MassHealth plays a critical role in advancing healthcare innovation, promoting health equity, and supporting the well-being of individuals, families, and communities across the Commonwealth. Learn more: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 visithttp://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. ADA Reasonable Accommodation: If you require a reasonable accommodation with the application/interview process, please contact us at: EOHHS Candidate ADA Requests. For questions, please contact the Executive Office of Health and Human Services Human Resources at 1-800-510-4122 and select option #4. 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. 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. Job: Administrative ServicesOrganization: Exec Office Of Health and Human Services Title: Health Safety Net Policy Manager Location: Massachusetts-Quincy - 1 Enterprise Dr Requisition ID: 260005QO
