Job Description

　　MassHealth is seeking dynamic community focused professionals for the role of Dental Program Coordinator.

　　The Dental Program Coordinator oversees all aspects of Dental program functions of the agency to support members and providers. Works collaboratively with stakeholders, sister agencies, and other affiliations to maintain a sustainable provider network for member access. The manager will manage and implement policy change to keep up with CMS guidelines and industry standards.

　　Duties and Responsibilities (these duties are a general summary and not all inclusive):

　　• Oversees all aspects of Dental program functions. Produces and works with budget on program expenditures.

　　• Monitors CMS policy changes and implements the various aspects of federal Medicaid policy requirements.

　　• Ensures maintenance of all necessary modifications to the agency's database, the Medicaid Management Information System (MMIS), as well as TPA systems, ensuring they are in alignment with program's expectations.

　　• Recommends and implements related MH regulations and/or policy changes as appropriate.

　　• Coordinates with program staff to ensure all program functions and provider relation issues are responded to and resolved in a timely manner.

　　• Works collaboratively with EHS programs and TPA staff in the management of dental program responsibilities; including claims processing, pricing and stakeholder relations.

　　• Utilizes current knowledge of healthcare delivery models in decision making regarding provider relations and program policy development.

　　• Analyzes dental program policies, expenditures and utilization data and recommend changes to increase the cost effectiveness and appropriateness of service delivery, identify efficient program management of claims payment practices, potential over payment situations and cost savings and recovery opportunities. Coordinates with Program Integrity Staff on recovery initiatives and internal or external program audits.

　　• Coordinates with TPA on the development of reports, analyzes program spending and utilization trends.

　　• Leads workgroups design to address specific issues and assures outcomes of these groups are resolved.

　　• Serve as the contact person for MMIS and the Third Party Administrator (TPA) on dental interface activities, issues, testing activities, change orders, etc.

　　• Track, review and analyze contractor reports and deliverables and make recommendations to program/contract managers for program improvements.

　　• Review and assess financial statements and payment vouchers.

　　• Perform related duties as assigned by the supervisor and unit Director.

　　Required Qualifications:

　　• Proficiency in Excel.

　　• Ability to use data-management software such as Access.

　　• Ability to learn and use Cognos.

　　• Ability to perform expenditure, utilization, and rate analyses.

　　• Knowledge of the health care industry.

　　• Knowledge of the methods of general report writing.

　　• Ability to coordinate the efforts of others in accomplishing assigned work objectives.

　　• Ability to write in a concise manner, express thoughts clearly and develop ideas in a logical sequence.

　　• Ability to manage complex projects impacting various units of the organization.

　　• Ability to organize and track very detailed information.

　　• Ability to maintain accurate records.

　　• Ability to prepare clear, concise reports and recommendations.

　　• Ability to communicate in a professional manner.

　　• Ability to assemble items of information in accordance with established procedures.

　　• Ability to give written and oral instructions in a precise, understandable manner.

　　• Ability to establish and maintain harmonious working relationships with others.

　　• Ability to exercise discretion in handling confidential information.

　　Preferred Qualifications:

　　Knowledge of rules, policies and regulations of the MassHealth dental program. Knowledge of the MMIS Claims Processing and Cognos System.

　　TO APPLY:

　　Please upload both Resume and Cover Letter for this position when applying. First consideration will be given to those applicants that apply within the first 14 days.

　　About MASSHEALTH:

　　To improve the health outcomes of our diverse members and their families by providing access to integrated health care services that promote sustainable & equitable health, well-being, independence and quality of life.

　　For more information about our agency and programs please visit: www.mass.gov/masshealth

　　Pre-Offer Process:

　　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

　　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.

　　If you require assistance with the application/interview process and would like to request an ADA accommodation, please click on the link and complete the Reasonable Accommodation Online Request Form.

　　For questions, please the contact the Office of Human Resources at 1-800-510-4122 and select option #4.

　　Qualifications

　　First consideration will be given to those applicants that apply within the first 14 days.

　　MINIMUM ENTRANCE REQUIREMENTS: Applicants must have at least (A) four years of full-time, or equivalent part-time, professional, administrative or managerial experience in business administration, business management or public administration the major duties of which involved program management, program administration, program coordination, program planning and/or program analysis, and (B) of which at least one year must have been in a supervisory capacity, or (C) any equivalent combination of the required experience and the substitutions below.

　　Substitutions:

　　I. A Bachelor's degree with a major in business administration, business management or public administration may be substituted for a maximum of two years of the required (A) experience.

　　II. A Graduate degree with a major in business administration, business management or public administration may be substituted for a maximum of three years of the required (A) experience.

　　III. A Bachelor's or higher degree with a major other than in business administration, business management or public administration may be substituted for a maximum of one year of the required (A) experience.

　　Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed.

　　NOTE: No substitutions will be permitted for the required (B) experience.

　　Comprehensive Benefits

　　When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.

　　Want the specifics? Explore our Employee Benefits and Rewards!

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

　　The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.