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PointHealth Hiring for Program Manager I – MassHealth Performance at Canton, MA Full Time
Job Description
Who We Are
Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.
We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click .
Job Summary
The MassHealth Performance Program Manager is responsible for coordinating projects and initiatives that support the success of the MassHealth Together Accountable Care Organization (ACO) and Managed Care Organization (MCO) products offered by the Public Plans Division, which are Medicaid health benefit plans funded or otherwise sponsored by the Massachusetts Executive Office of Health & Human Services (EOHHS). Key indicators of success include operating margin and medical loss ratio (MLR) performance, unit cost and utilization trends, and membership growth. This role, reporting to the Director of MassHealth Performance & Product Strategy, works closely with a cross-section of division and enterprise business and functional teams (operations, clinical services, population health, provider partnerships, finance, actuarial, risk adjustment, business performance, marketing, etc.) to achieve performance objectives. The MassHealth Performance Program Manager will occasionally interface with ACO provider partners and EOHHS to review historical performance and establish performance improvement goals. Key success factors of the role include tactical problem-solving skills, strong organizational and communication skills, ability to coordinate multiple workstreams, and a commitment to delivering efficient, high-quality health care coverage to vulnerable populations.
Key Responsibilities/Duties – what you will be doing
- At the direction of the Director of MassHealth Performance & Product Strategy, identify strategic priorities around product performance and implement performance metrics for ongoing tracking.
- Collaborate with enterprise functions such as actuarial services, risk adjustment, provider partnerships, operations, and population health to drive, monitor and track progress against performance objectives.
- Facilitate timely communication of relevant information regarding initiative priorities and deliverables to relevant internal and external stakeholders.
- Lead development of relevant reports and dashboards, to monitor initiative performance and progress.
Qualifications – what you need to perform the job
EDUCATION: (Minimum education required)
Bachelor’s Degree. (Master’s Health Administration or Master’s Public Health preferred.)
EXPERIENCE: (Years of experience)
- Minimum of 2 years of experience with a proven track record of project management success
- Health care or regulatory/government affairs background preferred
SKILL REQUIREMENTS: (Include interpersonal skills)
- Excellent verbal and written communication skills, ability to facilitate planning and review sessions
- High level presentation skills including ability to interface effectively with external stakeholders
- Ability to exercise sound judgment and raise issues to appropriate team members or management for resolution
- Ability to take complex problems and facilitate problem-solving effectively using internal resources and processes
- Ability to prioritize, organize and ensure follow through on multiple deliverables, simultaneously
- Ability to work effectively across functions and with people at all levels, including clinicians
- Must be a self-starter, able to think creatively, be extremely resourceful, and have a high energy level
Technical skills:
- Proficiency with MS Office applications (Word, Excel, PowerPoint)
- Ability to utilize multiple applications simultaneously
Interpersonal skills
- Requires the ability to work cooperatively as part of a team.
- Must be able to effectively communicate with all internal departments in verbal and written formats.
- Requires some presentation experience
- Must be able to work in a matrix environment with moderate supervision
WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS: (include special requirements, e.g., lifting, travel, overtime)
- Must be able to work under normal office conditions and work from home as required.
- Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
- May be required to work additional hours beyond standard work schedule.
CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.
*Essential functions occur simultaneously, therefore, the employee must be able to appropriately handle each essential function, prioritize them and seek assistance when necessary. These functions need to be performed on a consistent and regular basis, using good judgment. Ability to learn and apply company policies consistently, seeking out guidance when necessary, is required.
THIS DESCRIPTION IS NOT INTENDED TO BE A COMPLETE STATEMENT OF JOB CONTENT; RATHER IT ACTS AS A GUIDE TO THE ESSENTIAL FUNCTIONS PERFORMED. MANAGEMENT RETAINS THE DISCRETION TO ADD TO OR CHANGE THE DUTIES OF THE POSITION AT ANY TIME.
Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity
Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do-from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team’s strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
Point32Health is committed to making diversity, equity, and inclusion part of everything we do—from product design to the workforce driving that innovation. Our DEI strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
