The MassHealth Dental Program offers dental benefits to children, adults, seniors, and individuals with disabilities enrolled in MassHealth or related programs such as the Health Safety Net (HSN) and Children's Medical Security Plan. The program is administered by a Third-Party Administrator, DentaQuest, under contract with the Executive Office of Health and Human Services (EOHHS) and aims to improve oral health, increase provider participation, and streamline access to care. MassHealth is seeking dynamic, community-focused professionals for the role ofDental Program Coordinator.The incumbent will be responsible for providing dedicated operational and programmatic support for the day-to-day administration of the MassHealth Dental Program. The Dental Program Coordinator will report to the Deputy Director, Dental Contracts and Operations and serve as a central resource to support member and provider issue resolution, provider administration, program reporting and monitoring, eligibility and claims coordination, and oversight of the Third-Party Administrator. This individual will also support cross-functional coordination and follow-up on program priorities and action items. The goal is to strengthen MassHealth's Dental Program's ability to respond to operational issues, maintain effective oversight of program activities, and ensure timely coordination among MassHealth staff, providers, members, and the Third-Party Administrator. This individual will provide important continuity and infrastructure for the program while allowing supporting senior staff with strategic priorities, program oversight including codes and regulation updates,Centers for Medicare & Medicaid Services (CMS)mandated policy implementation, responding to and State audits, stakeholder engagements, interagency contracts and support, and emerging issues. The MassHealth Dental Program manages a high volume of email inquiries related to member & provider complaints, operational issues, eligibility and claims matters, reporting requirements, and coordination with the Dental Third-Party Administrator. These responsibilities require ongoing coordination across multiple internal teams and external stakeholders to ensure issues are addressed timely and effectively. Duties and Responsibilities (these duties are a general summary and not all inclusive): Assist in addressing member complaints. Assist in addressing provider complaints/inquiries from: o Member constituent department o Automated Health Systems o Direct provider email Assist with provider enrollment related processes and oversight Work internally with other teams to investigate and address member eligibility issues related to: o Eligibility aid categories, o Member ID linking Review and summarize findings and key takeaways from monthly reports including but not limited to: o Provider risk levels o Claims processing o Provider enrollment Work with DentaQuest and other MassHealth teams to resolve inquiries and questions Review and update member and provider facing materials Represent the Dental team at internal meetings Other duties as assigned Preferred Qualifications: Ability to coordinate the efforts of others in accomplishing assigned work objectives. Ability to understand, explain and apply the law, rules, regulations, policies and procedures of the MassHealth Dental Program. Ability to communicate effectively in oral and written presentation. Ability to compose comprehensive instructions, reports, policies and procedures. Ability to adjust to varying changing situations to meet emergencies or changing program requirements. Sufficient in Microsoft Office. 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 / / 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. / / Pre-Offer Process: A criminal 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. 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. First consideration will be given to those applicants that apply within the first 14 days. MINIMUM ENTRANCE REQUIREMENTS: Applicants must have at least (A) four years of full-time, or equivalent part-time, professional, administrative or managerial experience in business administration, business management or public administration the major duties of which involved program management, program administration, program coordination, program planning and/or program analysis, and (B) of which at least one year must have been in a supervisory capacity, or (C) any equivalent combination of the required experience and the substitutions below. Substitutions: I. A Bachelor's degree with a major in business administration, business management or public administration may be substituted for a maximum of two years of the required (A) experience. II. A Graduate degree with a major in business administration, business management or public administration may be substituted for a maximum of three years of the required (A) experience. III. A Bachelor's or higher degree with a major other than in business administration, business management or public administration may be substituted for a maximum of one year of the required (A) experience. Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed. NOTE: No substitutions will be permitted for the required (B) 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 Services Organization: Exec Office Of Health and Human Services Title: *Dental Program Coordinator Location: Massachusetts-Quincy - 1 Enterprise Dr Requisition ID: 260007E6
