Program Manager, Medicaid ACO
Steward Health Care Network (SHCN) takes pride in its community-based care model, which drives value-added tools and services to our communities, patients, physicians, and hospitals across the continuum of care. In addition, Steward Health Care Network promotes care coordination and collaboration within the network in order to provide high-quality, efficient care to patients. With Steward in the community, all residents can be sure that there is a world-class doctor close to where they live.
The network is also responsible for the implementation and execution of our managed care contracts, medical management services, quality improvement programs, data analysis, and information services.
Position Purpose: The Program Manager manages key programmatic components and initiatives of the Medicaid ACO program and provides support to assist in achieving Medicaid program goals.
- Develop, monitor, and maintain in-depth knowledge of Medicaid program rules and requirements, and translate those rules and requirements into business and operational execution, such as:
- Content for member facing materials and provider training
- Address provider questions
- Update and evaluate program design
- Support ACO re-procurement/implementation activities
- Aggregate data from operations and finance teams to monitor program performance, including maintaining a dashboard of process and outcome measures for ACO performance. Identify opportunities for program improvement, intervention, issue escalation, etc. grounded in regular performance monitoring
- Assist in developing and overseeing the Medicaid ACO programs and budgets, which includes but is not limited to Steward’s Delivery System Reform Incentive Payment (DSRIP), Flexible Services Program
- Staff the governance bodies of the Steward Medicaid ACO, including the governing board and its committees. Prepare agendas and materials for board and committee meetings, and coordinate development and submission of regulatory documentation
- Manage vendors for program initiatives, including contract compliance, budget, and performance against initiative goals
- Interface with regulators to participate in and report back on MassHealth program meetings, track and resolve any program issues escalated to Medicaid ACO team from Steward providers or members, track and obtain responses on program questions, etc.
- Other duties related to Medicaid program as assigned
Education / Experience / Other Requirements
- Bachelor’s degree required. Masters preferred
Years of Experience:
- 3+ years health care experience
- Experience managing programs, initiatives, projects.
- Experience working in a fast-paced environment
- Analytic skills to collect information from diverse sources and summarize the information and data to solve problems.
- Accuracy and attention to detail required
- Demonstrates ability to think critically and creatively
- Possesses specialized knowledge related to Medicaid
- Possesses strong interpersonal written and oral skills
- Possesses excellent time management skills with proven ability to effectively manage multiple tasks and priorities at one time.
- Ability to create, interpret, and disseminate information across multiple internal and external stakeholders
- Possesses strong project management techniques to take initiatives from idea to execution
- Ability to work as part of a team and collaborate with colleagues across departments in a highly matrixed environment
- Accepts flexibility in work schedule willingly. (e.g., periodic early morning or evening meetings)
- Requisite poise, judgment, and trustworthiness to represent Steward to internal and external groups
- Ability to adapt and respond to changes in environment and priorities
- Strong knowledge of standard computer software tools, including Microsoft Word, Excel, PowerPoint, Outlook; Visio, Project, and SharePoint
This position is subject to the COVID-19 Vaccination Policy for Steward Health Care Workforce. Employees in this position will be required to provide adequate proof of vaccination for COVID-19 by an FDA-approved vaccine prior to starting work. Steward will consider requests for exemptions from this vaccine requirement on the basis of medical condition or sincerely held religious belief in accordance with applicable Federal laws.
Steward Health Care is an Equal Employment Opportunity (EEO) employer. Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic.
Steward Health Care Network is taking additional, necessary preparations to ensure patients can receive compassionate care in a safe, carefully managed environment – with confidence and without fear.
Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience:
- Any COVID-19 related care takes place in designated areas away from other patients and their families.
- A stringent cleaning policy has been implemented throughout our facilities.
- A strictly controlled visitor and masking policy is required for patient and colleague safety.
You can rest assured that we have made the necessary preparations to provide care in a safe, controlled and professional way.