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Health New England
Springfield
Job Description Job Description Purpose 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 policie
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Regular Full-Time Professional Springfield, MA, US
3 days ago Requisition ID: 1549
Purpose
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 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.
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
Train new providers and appropriate primary care practice staff on Flexible Service and Community Partner program initiatives, requirements, and workflows
Pull program data, develop reports, and conduct ongoing analysis in accordance with Mass Health guidance and quality improvement initiatives
Verify member eligibility for enrollment in programs from various sources such as provider referrals
Act as a liaison with contracted Community Partners, Social Service Organizations, and primary care practices for any ad hoc needs
Coordinate and facilitate Community Partner and Flexible Services Meetings
Troubleshoot any payment and billing issues that may occur in either program
Act as the subject matter expert for Flexible Services and Community Partner program specifications, guidance, and requirements provided by Mass Health
Develop training materials and workflows for each program to be used for spreading knowledge regarding program requirements
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.
Preferred Two (2) years of administrative and program coordination experience in a health care setting All
Microsoft office product knowledge and experience particularly excel.
Demonstrated experience supporting program operations through successful completion of tasks and projects
Strong analytical skills to develop and analyze options, and recommend solutions for complex problems and issues
High attention to detail and ability to interpret complex polices, rules and regulations
Ability to manage multiple priorities, establish workflows and meet necessary deadlines
Strong organizational, decision-making and problem-solving skills
Excellent facilitation, conflict resolution and interpersonal skills
Demonstrated success in facilitating or supporting quality improvement efforts
Ability to generate professional, clearly written communication that is tailored to the audience
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Program Coordinator- Flexible Services & Comm jobs in Springfield, MA, United States
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