Overview

JOB SUMMARY:

Under the general direction of the MassHealth Chief Medical Officer/Director of OCA, or designee, the Senior Program Manager for MassHealth Health Equity Programs works directly with MassHealth Program and Office of Clinical Affairs leadership in the development and implementation of a cohesive approach to measuring and incentivizing health equity for MassHealth members.

Responsibilities

ESSENTIAL FUNCTIONS:

Health Equity Program Strategy, Design and Communication:

• Lead, in partnership with MassHealth program teams, strategy and design of health equity programs including for accountable care organizations and acute hospitals
• Lead, in partnership with MassHealth program teams, programmatic strategy and design including related to:
  • Selection of quality and health equity measures
  • Setting of performance targets
  • Establishing and testing performance assessment methodologies
  • Iterating on program design
  • Reporting
  • Evaluation
  • Performance Management
• Together with MassHealth Quality Office leaders, contribute to the development and ongoing maintenance of the MassHealth Quality Strategy
• Regularly report to OCA leadership and staff (and other entities, at OCA leadership direction) on the status of MassHealth quality and health equity measurement programs and progress towards quality and health equity priorities.
• Support internal and external communications planning ensuring that key stakeholders are included and well informed, including providing expertise to internal workgroups

Health Equity Program Implementation and Monitoring:

• Lead, in partnership with MassHealth program teams, implementation of MassHealth health equity measurement and value-based purchasing programs including for accountable care organizations and acute hospitals
• Monitor and analyze health equity measurement program performance
• Monitor, analyze, and report on health equity measure performance
• Lead and/or support MassHealth program teams in developing and implementing health equity performance management activities
• Lead performance remediation activities, as applicable
• Manage necessary health equity analytics resources to support MassHealth health equity program functions, including by coordinating and overseeing inputs from OCA and MassHealth data and analytics staff

Health Equity Stakeholder Engagement:

• Lead stakeholder engagement and education activities with external stakeholders (including providers, health system representatives, federal authorities including CMS, members, and other stakeholders) through activities such as leading regular office hours, maintaining stakeholder requests, and through other venues as assigned
• Manage negotiations with CMS, as needed, to support continued authority for quality and health equity measurement programs
• Lead and/or support relevant MassHealth program advisory groups, including by preparing materials, managing activities, and being accountable for necessary follow-up activities
• Engage and oversee contracted vendors, as appropriate, on MassHealth quality and health equity measurement program-specific deliverables

Cross-Cutting Quality Initiatives:

• Serve as a subject matter expert for MassHealth quality and health equity measurement programs
• Contribute to design and implementation of cross-cutting quality and equity initiatives that impact multiple programs within MassHealth
• Hire, advise and directly supervise and evaluate performance of other staff. Provide functional supervision of other specific project/program staff as needed. Serve as a Health Equity management expert, building infrastructure to support the enrichment and professional development of the new team.Review and monitor compliance with the federal and state regulations.
• Perform other duties as required.

Qualifications

REQUIRED QUALIFICATIONS:

• Masters Degree in Health Care or Business Administration, Public Health, or a quality related health care field.
• 4-7 years experience leading/implementing health care quality and/or equity measurement and performance programs
• Experience with accountable care organization and/or acute hospital quality measurement
• Experience in a recent management/supervisory role
• Excellent communication and presentation skills, both oral and written, to interact with leadership, staff, providers and other stakeholders.

PREFERRED QUALIFICATIONS:

• Experience with Medicaid quality measurement programs
• Experience with health equity measurement
• Experience with quality measure development
• Quality analytics experience, including use of Medicaid claims data
• Flexibility and ability to thrive in a fast-paced, dynamic environment.