State of Massachusetts Manager, MassHealth Program Integrity in Quincy, Massachusetts

The Program Integrity Analytics Manager is a subject matter expert in all MassHealth policies, procedures and regulations and supporting systems, MA-21, MMMIS, Cognos. The Manager will also act as a consultant and advisor to Senior Leaders at MassHealth to provide feedback on the issues and concerns identified which may entail a new MMIS edit, a regulation/policy change

The Manager of Program Integrity Analytics oversees high-priority, inter-departmental projects including 1) restructuring of provider regulations, 2) identification and implementation of operational improvements, 3) identification and implementation of program integrity solutions, and 4) other urgent program integrity priorities. For each such initiative, the Manager works with the Director of Program Integrity Analytics and oversees a cross-functional team including representatives from MassHealth program, policy, legal, and IT units to develop work plans, generate innovative program integrity ideas, conduct analysis, and propose solutions to the MassHealth executive team. The Manager also engages with external stakeholders, MassHealth members, advocates, providers, and payors, as necessary to collect input and ensure policy objectives are implemented smoothly.

The Manager is ultimately accountable for executing successful projects that have meaningful impact on MassHealth members’ lives and/or generate material savings to the Commonwealth

A criminal background check will be completed on the recommended candidate as required by the regulations set forth by the Executive Office of Health and Human Services prior to the candidate being hired. For more information, please visit http://www.mass.gov/hhs/cori and click on "Information for Job Applicants".


  • Education, licensure and certifications will be verified in accordance with the Human Resources Division’s Hiring Guidelines

Education and license/certification information provided by the selected candidate(s) is subject to the Massachusetts Public Records Law and may be published on the Commonwealth’s website.

For questions, please contact the CYF Office of Human Resources at 1-800-510-4122 and select option #2.

MINIMUM ENTRANCE REQUIREMENTS:

Applicants must have at least (A) four (4) years of full-time or, equivalent part-time, professional, professional internship, administrative, supervisory, or managerial experience in business administration, business management, public administration, public management, clinical administration or clinical management or (B) any equivalent combination of the required experience and substitutions below.

Substitutions:

I. A certificate in a relevant or related field may be substituted for one (1) year of the required experience.

II. An Associate’s degree in a related field may be substituted for one (1) year of the required experience.

III. A Bachelor’s degree in a related field may be substituted for two (2) years of the required experience.

IV. A Graduate degree in a related field may be substituted for three (3) years of the required experience.

V. A Doctorate degree in a related field may be substituted for the required experience.

An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.

Job: *Management

Organization: *Exec Office Of Health and Human Services

Title: Manager, MassHealth Program Integrity

Location: Massachusetts-Quincy - 1150 Hancock Street

Requisition ID: 1700040X