Medicaid Special Programs Specialist

Job Description

Job Description

Purpose

The Medicaid Special Programs Specialist contributes to the overall success of the Medicaid ACO Department ensuring specific individual goals, plans; initiatives are executed / delivered in support of the team’s business strategies and objectives. Ensures all activities conducted are in compliance with governing regulations, internal policies and procedures. With direction and support from the Medicaid Program Manager, this role will responsible for executing the operational and reporting requirements for both the Mass Health Community Partners (CP) and Flexible Services Programs. This includes making referrals and assignments into the CP program, occasional quality assurance on referrals and data entries, acting as a key contact for external partners, coordination and facilitation of team meetings, training and educating key personnel, and any data / reporting back to the state. This position is responsible for managing large, complex projects (IT and Programmatic) of the Medicaid ACO. This includes developing and meeting project objectives within established timelines, and managing associated risks. The Program Coordinator-Mass Health Community Partners / Flexible Services works with primary care practices, community partners, consultants, vendors, internal & external customers, subject matter experts, and cross-functional teams. Responsibilities include providing periodic updates and reports to ELT and the Director’s Team.

Accountabilities

• Champions a customer focused culture to deepen client relationships and leverage broader Health New England’s relationships, systems and knowledge.
• Understand how Health New England’s culture and the CX Promise should be considered in day-to-day activities and decisions.
• Actively pursues effective and efficient operations of their respective areas in accordance with Health New England’s Values, its Code of Conduct and the Associate Handbook, while ensuring the adequacy, adherence to and effectiveness of day-to-day business controls to meet obligations with respect to operational, compliance, and conduct.
• Champions a high performance environment and contributes to an inclusive work environment.

Essential Functions

Operations Oversight

Impact Assessments and Solution Recommendations; Product Systems Support and Interoperability

Education / Experience / Other Information (include only those that are specific to the role)

Bachelor’s Degree in Health Care Administration, Public Health, Social Work, Business Administration or related field with a minimum of 3-5 years of relevant administrative and program coordination experience. , or an equivalent combination of education and experience.

Working Conditions

Standard office environment, with extended period of time sitting, looking at monitors, typing on laptops and communicating via softphones / headsets for virtual meetings. Traveling may be required.