Overview
GENERAL SUMMARY OF POSITION: Working as a member of the Medicare Eligibility Enhancement Programs Team at Health Care Finance Solutions (HCFS), the Medicare Savings Program Manager oversees all daily operations of the Medicare Savings Program (MSP) Unit. The MSP Unit administers the program on behalf of MassHealth and the Massachusetts Executive Office of Health and Human Services. Under the guidance of the Director or designee, the Manager implements and manages MSP policies, oversees program reporting, enhances operations, and supervises staff. The Manager acts as a liaison with state and federal agencies, community resources, and program recipients to exchange information, coordinate activities, provide training, and resolve issues. The primary goal is ensuring the accuracy of Medicare premium transactions, supporting Medicare benefits coordination, and maintaining MassHealth as the Payor of Last Resort.
Responsibilities
MAJOR RESPONSIBILITIES:
1. Evaluate and implement operational efficiencies by reviewing reports and staffing information.
2. Support and oversee revenue programs by monitoring progress and analyzing data.
3. Perform supervisory duties, including hiring, corrective actions, and performance evaluations.
4. Recommend priorities and program improvements.
5. Monitor revenue activities to identify risks and opportunities.
6. Assist in developing and enforcing policies and procedures for program monitoring and evaluation.
7. Oversee activities within the assigned unit.
8. Participate in revenue management projects.
9. Identify state programs eligible for Federal Financial Participation (FFP).
10. Provide on-the-job training and orientation for staff.
11. Develop procedures and guidelines to meet project objectives.
12. Analyze project data to assess progress and effectiveness, recommending procedural changes as needed.
13. Respond to inquiries related to projects from EOHHS staff and others.
14. Attend staff meetings, maintain records, and prepare reports.
15. Represent the department professionally with EOHHS and other agencies.
16. Collaborate internally and externally to resolve discrepancies.
17. Perform additional duties as assigned.
Qualifications
REQUIRED QUALIFICATIONS:
* Bachelor’s Degree or equivalent in Finance, Public Administration, Business, or related field.
* 5-7 years of experience in fiscal management, finance, or public administration.
* Proven skills in financial or operational management.
* Thorough knowledge of funding and revenue sources for health and human services programs.
* Understanding of federal and Massachusetts regulations related to entitlement and block grants.
* Experience with contract development and management.
* Strong management and leadership abilities.
PREFERRED QUALIFICATIONS:
* Knowledge of MassHealth and Medicare Premium Assistance eligibility requirements.
* Experience working with federal health and human services agencies like SSA and CMS.
* Knowledge of healthcare reform law, including the ACA.
* Familiarity with MassHealth systems such as MA21 and MMIS, and data interpretation skills.
* Proficiency in preparing and presenting various reports.
* Ability to monitor large data transactions for accuracy and timeliness.
* Knowledge of quality assurance for complex data files.
* Attention to detail and strong data analysis skills.
* Experience handling Protected Health Information (PHI) and Personally Identifiable Information (PII).
* Ability to synthesize complex information and communicate clearly.
Additional Information
About HCFS and the MEEP Team: HCFS, part of ForHealth Consulting at UMass Chan Medical School, specializes in health care reform initiatives. Located in Shrewsbury, MA, HCFS helps state agencies optimize savings and revenue through federal and third-party sources, while expanding health services and reducing costs. The Medicare Eligibility Enhancement Programs (MEEP) Team collaborates with Medicaid programs to identify and coordinate benefits, ensuring recipients receive all entitled benefits and generating cost savings and revenue for Medicaid agencies.
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