Job Description
The Program Manager, Accountable Care Organization (ACO) Performance will drive holistic performance of contracted, provider-led ACOs against goals to contain cost while improving quality and member experience.
The MassHealth ACO program launched in 2018 and is an innovative, statewide program to improve care and control health care costs for approximately 1 million of the state's Medicaid members. The program consists of 17 provider-led organizations, who may or may not partner with health plans, that emphasize care coordination and member-centric care. These organizations cover the majority of health care systems across the state, both large and small. They have financial incentives to control avoidable cost growth, improve clinical quality, and enhance the member experience of care under a value-based care model.
As the Program Manager of ACO Performance, you will have the opportunity to 1) consolidate and analyze ACO quantitative and qualitative performance data, 2) identify improvement areas for individual ACOs, 3) prepare and give presentations to key internal and external stakeholders synthesizing findings and recommendations, 4) manage conversations with ACOs on remediation of performance deficits, and 5) lead internal strategic projects related to ACO performance. You will be responsible for reading out to senior MassHealth leadership, working in direct partnership with ACOs to better understand performance trends, and understanding individual ACO population health and other strategies to impact cost and improve member care. This will require working cross-functionally across various MassHealth teams such as finance, quality, clinical operations, policy, and various program teams.
This would be a good role for someone passionate about driving change in health care for underserved populations and has prior experience with data analysis, health care finance or management, population health and/or public health.
This role will sit within the ACO performance team which is positioned within the agency's larger Payment and Care Delivery Innovation (PCDI) team. PCDI manages new models of accountable and coordinated care for patients, including the ACO, Community Partner, Flexible Services, and Statewide Investment programs.
Duties and Responsibilities (these duties are a general summary and not all inclusive):
Performance Management
Lead external meetings with individual ACOs, building relationships to align with ACOs on strategies to improve their outcomes in line with the goals of the programDraft PowerPoints showing data on ACO performance deficits in a compelling and easy to understand mannerAssist in the development, implementation and monitoring of specific initiatives designed to address identified performance gaps (ACO -specific and, to some extent, program wide)Contribute to the broader strategy development for identification and prioritization of poor-performing ACOs for management Collaborate with clinical, quality measure, finance, and other program teams to understand and apply appropriate context and information to ACO performance engagements
ACO Performance Analysis
Data analysis and synthesis on financial, quality, and utilization data to identify areas when an ACO is underperformingDraft recommendations and conclusions based on synthesis of quantitative outcomes data on financial, quality, and utilization, with qualitative information on an ACO's population health strategy, strengths, and weaknessesDevelop recommendations, draft memos and presentations for senior and exec-level staff when appropriateCommunicate to internal and external parties
Ad Hoc Data Requests
Respond to ad hoc inquiries and requests for information from external stakeholders including other MassHealth units, other state agencies, and public entities.Assist senior level staff with various financial policy analyses, ACO performance reporting projects, etc.
Preferred Qualifications:
Bachelor's Degree, Master's Degree preferred Passion for public serviceExcellent analytical and problem solving skills2-4 years' experience working in analytical capacityExcellent MS Excel and PowerPoint skills and experience analyzing large datasets using Microsoft ExcelExperience using Tableau a plus, but not requiredExcellent organizational skills and attention to detailAbility to parse complicated problems with minimal direction, and clearly communicate findings to a variety of stakeholders (internal and external)Ability to lead projects through organizing work, establishing operating relationships, and coordinating the work of othersAbility to analyze and determine the applicability of financial and program data, to draw conclusions, and to make appropriate recommendationsStrong written and verbal communication skillsStrong interpersonal skillsExperience in healthcareEnjoy working inhigh paced environment, often including tight time constraints
Note: This is a hybrid role, working in the Boston based office 1-2 days a week
Agency Mission:
To improve the health outcomes of our diverse members and their families by providing access to integrated health care services that 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.
TO APPLY:
Please upload both Resume and Cover Letter for this position when applying.
Qualifications
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.
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.