MassHealth is Massachusetts’s Medicaid and Children’s Health Insurance Program (CHIP). MassHealth provides comprehensive, affordable health care coverage for over two million low-income Massachusetts residents, including 40% of all Massachusetts children and 60% of all residents with disabilities. MassHealth’s mission is to improve the health outcomes of our diverse members and their families by providing access to integrated health care services that sustainably and equitably promote health, well-being, independence, and quality of life. 

The Contract Management and Operations (CMO) team is part of the Office of Accountable Care and Behavioral Health and is tasked with the oversight and management of MassHealth’s Accountable Care Organizations (ACOs), Managed Care Organization (MCOs), Primary Care Clinician (PCC) Plan, and MassHealth's contracted behavioral health vendor, the Massachusetts Behavioral Health Partnership (MBHP). The ACOs, MCOs, PCC Plan and MBHP are responsible for delivering services to more than 1.5 million MassHealth members and are key partners in improving health care outcomes and driving innovation.

ACOs are the central managed care delivery system of MassHealth’s current 1115 Demonstration, which has been a critical tool in enabling Massachusetts to achieve and maintain near-universal health coverage, sustain the Commonwealth’s safety net health system, expand critical behavioral health services, and implement reforms in the way that care is delivered. MassHealth ACOs initially launched in 2018 and 17 new ACOs were launched in 2023. ACOs are provider-led managed care organizations accountable for improving quality of care, member experience, and total cost of care. Since 2018, ACOs have transitioned care for over a million members from a largely fee-for-service system towards a value-based payment model where providers are accountable for managing the health of their membership.

As Deputy Director of Health Plan Administration, the incumbent will manage a team to drive towards improved healthcare outcomes for members, as well as robust and high-quality service delivery and streamlined administrative processes. The Deputy Director will be responsible for managing relationships with key staff across other MassHealth offices (such as Enrollment Operations, the Office of Long Term Services and Supports (OLTSS), the Pharmacy Office, etc.) and working with them to identify pain points and implement improvements. The incumbent will also be working closely with staff within Accountable Care and Behavioral Health to understand program priorities and present recommendations to unit and MassHealth Leadership.

The Deputy Director of Health Plan Administration will be expected to oversee multiple efforts in a fast-paced, cross-functional work environment, and coordinate workstreams across multiple teams throughout Accountable Care and Behavioral Health and the agency. They will need to have a working understanding of how technology systems operate in the healthcare space, be passionate about driving change in health care for underserved populations, demonstrate project management expertise, be attentive to detail and have excellent communication skills.

Duties and Responsibilities (these duties are a general summary and not all inclusive):

Lead administrative management for MassHealth’s Accountable Care Organization (ACO), Managed Care Organization (MCO), and Primary Care Clinician Plan health plans. Drive special projects and cross-team process improvement efforts to further enhance the efficiency and continued compliance of the MassHealth managed care health plans. Manage relationships with health plans. Manage (including developing and recruiting, where applicable), a performance-oriented, high-profile team of capable contract managers and analysts. Support other MassHealth priorities and teams when work intersects with MassHealth health plans.

Preferred Qualifications:

Excellent analytical and problem-solving skills. Excellent communication skills. Excellent facility with Accountable Care Organization (ACO) and Managed Care Organization (MCO) program content. Comfort with multitasking. Comfort with working under high pressure and tight time constraints. Ability to take ownership of workstreams with high-level direction and guidance. Ability to provide structure and process management to the projects. Strong interpersonal skills.Passion for public service.Experience working in analytical capacity. Background in healthcare management or policy preferred.Ability to set goals and strive for excellence or improvement.Ability to identify a problem or opportunity and take action to address current or future problems and opportunities.Ability to think through problems, organize information, and identify key factors and underlying causes to generate solutions.Ability to work cooperatively with others and be part of a team.

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 theReasonable 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.

MassHealth is Massachusetts’s Medicaid and Children’s Health Insurance Program (CHIP). MassHealth provides comprehensive, affordable health care coverage for over two million low-income Massachusetts residents, including 40% of all Massachusetts children and 60% of all residents with disabilities. MassHealth’s mission is to improve the health outcomes of our diverse members and their families by providing access to integrated health care services that sustainably and equitably promote health, well-being, independence, and quality of life. 

The Contract Management and Operations (CMO) team is part of the Office of Accountable Care and Behavioral Health and is tasked with the oversight and management of MassHealth’s Accountable Care Organizations (ACOs), Managed Care Organization (MCOs), Primary Care Clinician (PCC) Plan, and MassHealth's contracted behavioral health vendor, the Massachusetts Behavioral Health Partnership (MBHP). The ACOs, MCOs, PCC Plan and MBHP are responsible for delivering services to more than 1.5 million MassHealth members and are key partners in improving health care outcomes and driving innovation.

ACOs are the central managed care delivery system of MassHealth’s current 1115 Demonstration, which has been a critical tool in enabling Massachusetts to achieve and maintain near-universal health coverage, sustain the Commonwealth’s safety net health system, expand critical behavioral health services, and implement reforms in the way that care is delivered. MassHealth ACOs initially launched in 2018 and 17 new ACOs were launched in 2023. ACOs are provider-led managed care organizations accountable for improving quality of care, member experience, and total cost of care. Since 2018, ACOs have transitioned care for over a million members from a largely fee-for-service system towards a value-based payment model where providers are accountable for managing the health of their membership.

As Deputy Director of Health Plan Administration, the incumbent will manage a team to drive towards improved healthcare outcomes for members, as well as robust and high-quality service delivery and streamlined administrative processes. The Deputy Director will be responsible for managing relationships with key staff across other MassHealth offices (such as Enrollment Operations, the Office of Long Term Services and Supports (OLTSS), the Pharmacy Office, etc.) and working with them to identify pain points and implement improvements. The incumbent will also be working closely with staff within Accountable Care and Behavioral Health to understand program priorities and present recommendations to unit and MassHealth Leadership.

The Deputy Director of Health Plan Administration will be expected to oversee multiple efforts in a fast-paced, cross-functional work environment, and coordinate workstreams across multiple teams throughout Accountable Care and Behavioral Health and the agency. They will need to have a working understanding of how technology systems operate in the healthcare space, be passionate about driving change in health care for underserved populations, demonstrate project management expertise, be attentive to detail and have excellent communication skills.

Duties and Responsibilities (these duties are a general summary and not all inclusive):

Lead administrative management for MassHealth’s Accountable Care Organization (ACO), Managed Care Organization (MCO), and Primary Care Clinician Plan health plans. Drive special projects and cross-team process improvement efforts to further enhance the efficiency and continued compliance of the MassHealth managed care health plans. Manage relationships with health plans. Manage (including developing and recruiting, where applicable), a performance-oriented, high-profile team of capable contract managers and analysts. Support other MassHealth priorities and teams when work intersects with MassHealth health plans.

Preferred Qualifications:

Excellent analytical and problem-solving skills. Excellent communication skills. Excellent facility with Accountable Care Organization (ACO) and Managed Care Organization (MCO) program content. Comfort with multitasking. Comfort with working under high pressure and tight time constraints. Ability to take ownership of workstreams with high-level direction and guidance. Ability to provide structure and process management to the projects. Strong interpersonal skills.Passion for public service.Experience working in analytical capacity. Background in healthcare management or policy preferred.Ability to set goals and strive for excellence or improvement.Ability to identify a problem or opportunity and take action to address current or future problems and opportunities.Ability to think through problems, organize information, and identify key factors and underlying causes to generate solutions.Ability to work cooperatively with others and be part of a team.

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 theReasonable 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) six (6) years of full-time or, equivalent part-time, professional, administrative, supervisory, or managerial experience in business administration, business management, public administration, public management, clinical administration or clinical management of which (B) at least two (2) years must have been in a project management, supervisory or managerial capacity or (C) 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 (A) experience.

II. A Bachelor's degree in a related field may be substituted for two (2) years of the required (A) experience.

III. A Graduate degree in a related field may be substituted for three (3) years of the required (A) experience.

IV. A Doctorate degree in a related field may be substituted for four (4) years of the required (A) 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.

MINIMUM ENTRANCE REQUIREMENTS:

Applicants must have at least (A) six (6) years of full-time or, equivalent part-time, professional, administrative, supervisory, or managerial experience in business administration, business management, public administration, public management, clinical administration or clinical management of which (B) at least two (2) years must have been in a project management, supervisory or managerial capacity or (C) 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 (A) experience.

II. A Bachelor's degree in a related field may be substituted for two (2) years of the required (A) experience.

III. A Graduate degree in a related field may be substituted for three (3) years of the required (A) experience.

IV. A Doctorate degree in a related field may be substituted for four (4) years of the required (A) 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.