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ACO Program Manager & State Liaison MassHealth

Job ID 147864 Date posted 06/12/2018

Position Summary:
The ACO Program Manager & State Liaison (Program Manager) is responsible for managing the overall implementation plan for the MassHealth ACO. This includes tracking reporting and auditing requirements (e.g., expenditure summary reports, progress reports, etc.), overseeing record keeping, supporting the Director of Quality and Performance as needed, and project managing auditing and inspection of records as applicable. As State Liaison, the Program Manager will be the primary contact for MassHealth, including all matters related to document requests, revisions, arranging for site visits, fielding state inquiries, and preparing for and attending all state meetings (in person where applicable).

Reporting to the Executive Director, the Program Manager will support efforts to increase provider enrollment in the ACO and will flag concerns with respect to provider performance or participation as necessary.

Essential Duties & Responsibilities (including but not limited to):
1. Manage day to day operations, policies, and procedures of the MassHealth ACO
2. Draft all deliverables as requested by the state (by contract or on an ad hoc nature)
3. Ensure deliverables due to MassHealth are reviewed, refined, and submitted in a timely manner
4. Support the Executive Director in the creation of materials for board and committee meetings
5. Prepare agendas and run weekly operational meetings
6. Serve as the primary contact to MassHealth, including regular phone calls, attending all meetings, and responding to state requests for information
7. Update the Executive Director regularly on all state inquiries, concerns, and requests
8. Track and report to the state on all patient access concerns
9. Support the operational relationship with the MassHealth managed care organizations, in collaboration with the Executive Director
10. Collaborate with the Director of Data and Performance Analytics to produce regular performance dashboards
11. Collaborate with the Director of Quality and Analytics to track performance across quality measure slate
12. Plan, develop, and review materials for member and provider ACO education
13. Participate in the process of identification of performance improvement projects, including creating associated analytics and financial justification. Provide additional supportive analytics as necessary
14. Communicate effectively with cross-functional teams
15. Track and ensure expenses stay within 5 year DSRIP and LCPN budgets
16. Collaborating with LCPN team members, develop a reporting methodology for quality and financial information to physician members
17. Maintain global budget performance reporting for physicians and hospitals
18. Provides supervision and mentorship to project management and administrative support staff
19. Establish and implement project communication plan including progress reporting mechanism to keep project sponsor, key stakeholders, senior management, and various committees up to date with the progress of ACO related projects
20. Design and maintain information systems capabilities to support efficient contract management, support individual patient care management, and to allow accumulation of data for population management (by physician practice and ACO wide)
21. Complete other duties as assigned


Minimum Qualifications

Education: A Master's degree in Public Health, Business, Healthcare Administration, or related field

Licensure, Certification & Registration: None

- 5-7 years of related experience.
- Experience with State agency payers
- Experience with health care providers.
- Experience with measurement, reporting, and improvement activities.

Skills, Knowledge & Abilities:
- Proven track record of formulating and monitoring strategies that have positioned the organization for success within an advanced managed care marketplace.
- Experience with contracts with significant quality performance incentives.
- Experience tracking budgets.
- Substantive, working knowledge of healthcare finance.
- Knowledge of the Massachusetts health care system, its nuances and market dynamics. Thorough understanding of current trends and best practices is required.
- Excellent written, verbal, and interpersonal communications skills, including the ability to translate the language of healthcare finance into practical and useful daily operations information.
- Excellent presentation skills and the ability to facilitate diverse group discussions that progress towards consensus.
- Proactive and creative problem solving skills.
- Strong project management skills. Able to balance competing priorities, complex situations, and tight deadlines.
- Proven success managing a multiplicity of relationships and maintaining each with equal priority.
- Conducts oneself with integrity and the highest ethical behavior and role models this behavior.
- Strong computer skills.



About Lahey Health

The Lahey Model of Care - right care, right time, right place - is exactly what patients, providers and payers need and deserve. Identifying and delivering on this convergence of interests has positioned Lahey Health for further growth. Our model ensures care is highly coordinated and locally delivered, with lower costs and exceptional quality.

Lahey Health is a robust, regional system including a teaching hospital, community hospitals, primary care providers, specialists, behavioral and home health services, skilled nursing and rehabilitation facilities, and senior care resources throughout northeastern Massachusetts and southern New Hampshire. The system has a global presence with programs in Canada, Jordan and Bermuda.

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