Home
/
Comprehensive
/
Provider Network Specialist - Western Mass
Provider Network Specialist - Western Mass-February 2024
Northampton
Feb 3, 2025
About Provider Network Specialist - Western Mass

  The Department of Mental Health (DMH) is seeking aProvider Network Specialist (PNS)to play a critical part in ensuring the effectiveness and compliance of contracted community programs in the Western Massachusetts Area. As a PNS, you will leverage your analytical skills to review and analyze data from diverse sources, such as billing and utilization records, quality measures, licensing reports, and service contracts. Your keen insights will be crucial in assessing compliance with program standards and identifying performance trends. You will also collaborate closely with Site and Area office staff, as well as Central Office teams responsible for licensing, Medication Administration Program (MAP), utilization management, and contract administration. Your involvement in work groups will contribute to the development, implementation, monitoring, and enhancement of contract and performance management processes. As a key member of the Western Massachusetts Area Office team, you will actively participate in internal and external meetings, sharing valuable information, analysis, and recommendations with Area Leadership, DMH Site Offices, and provider representatives. The PNS position goes beyond traditional contract management responsibilities. You will actively contribute to the improvement of administrative contract management tasks, such as streamlining invoice approval processes and conducting data quality audits. Furthermore, your role extends to developing and delivering training and technical assistance on contract-related processes and priorities, ensuring that knowledge is shared and standards are consistently met across the provider network. If you are passionate about mental health and possess the analytical and collaborative skills necessary for this role, we invite you to join us in making a positive impact on the community's well-being. This position is a full-time 37.5 hour/week role with Saturday/Sunday as the days off. /_Duties and Responsibilities (these duties are a general summary and not all inclusive)_//:/ * Review, summarize and analyze data from multiple sources (e.g., billing and utilization data, quality measures, licensing reports, meeting minutes, service contracts, etc.) to assess compliance with contract and service requirements and performance trends. * Provide recommendations on areas of improvement for contracted programs and track progress of performance improvement initiatives, corrective action plans and other follow-up actions. * Assist with administrative contract management tasks (e.g., invoice approval, record reviews, data quality audits). * Develop tools to monitor contract/program compliance, performance, and improvement. * Update, modify, and/or develop correspondence, meeting agendas, minutes, materials, and schedules. * Develop and deliver training and technical assistance on contract-related processes and priorities (e.g., data submission, billing, contract expectations, etc.). * Attend and/or assist in convening internal and external meetings related to provider performance. * Regularly share information, analysis, and recommendations with Area Leadership, DMH Site Offices, and provider representatives. * Serve as a resource and content expert for Site and Area personnel related to contract compliance, trends, outcomes, and performance. * Coordinate within the Area, across Areas, and with Central Office to ensure alignment of service standards and expectations. /_Required Qualifications_//:/ * Knowledge of methods for qualitative and quantitative review, summary, and analysis. * Excellent communication and judgment skills. * Ability to maintain accurate and concise records. * Ability to prioritize and multitask duties based on assignment and urgency of tasks. * Ability to use discretion when handling confidential information. * Ability to gather information by examining records and documents and by communicating directly with individuals. /_Preferred Qualifications_//:/ * Knowledge of State laws, rules, regulations, policies, procedures, specifications, standards, and guidelines governing agency. * Knowledge of DMH regulations, contracts, policies, and procedures, and community services. * Proficiency with MS Office including Outlook, Teams, Word, Excel, and PowerPoint, and business intelligence tools. * Given the population served, bilingual or multilingual fluency. /_DMH Mission Statement:_/ The Department of Mental Health assures and provides access to services and supports to meet the mental health needs of individuals of all ages, enabling them to live, work and participate in their communities. The Department establishes standards to ensure effective and culturally competent care to promote recovery. The Department sets policy, promotes self-determination, protects human rights, and supports mental health training and research. _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 regarding this requisition, please contact Employment & Staffing at 1 (800) 510-4122, Option 4. 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! * COVID Vaccine: As a condition of employment, depending on job assignment and location, employees may be required to have received COVID-19 vaccination and/or other vaccinations, or to have been approved for a vaccination exemption prior to their start date. Details relating to demonstrating compliance with this requirement will be provided to applicants selected for employment. 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. *Job: Administrative Services *Organization: Department of Mental Health *Title: *Provider Network Specialist - Western Mass Location: Massachusetts-Northampton-1 Prince Street Requisition ID: 240000B6

Comments
Welcome to zdrecruit comments! Please keep conversations courteous and on-topic. To fosterproductive and respectful conversations, you may see comments from our Community Managers.
Sign up to post
Sort by
Show More Comments
SIMILAR JOBS
Knowledge Manager
Knowledge ManagerJob LocationsUS-OH-WPAFBID2023-7577CategoryOtherTypeRegular Full-TimeOverviewCredence Management Solutions, LLC (Credence) is seeking a Knowledge Manager in support of the Cyber Resi
Traveling Dental Assistant
Starting wage from $23 to $38 per hour, depending on experience. Full time Travel Dental Assistant, offering consistent hours with a schedule of 4, 10-hour days per week. Generous benefits included!
Greeter
In most jobs, everyone doesn’t spontaneously erupt into applause and start raining down high-fives. At Buffalo Wild Wings, that’s just a Thursday night. This is the place to start the next phase of y
Shift Manager
In most jobs, everyone doesn’t spontaneously erupt into applause and start raining down high-fives. At Buffalo Wild Wings, that’s just a Thursday night. This is the place to start the next phase of y
Operational Risk Control Testing Lead
Job Summary The Operational Risk Control Testing Lead position may be an individual contributor or may function as a team leader of a small group responsible for assessing the operational risk of the
Pharmacy Manager
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced
Completions Mechanical Technician
Summary of Position         Perform inspections, repairs, service and modifications to the helicopters airframe and engines.   Essential Duties and Responsibilities: * *Perform inspections, repairs,
Greeter
In most jobs, everyone doesn’t spontaneously erupt into applause and start raining down high-fives. At Buffalo Wild Wings, that’s just a Thursday night. This is the place to start the next phase of y
Spanish Speaking EMT/Paramedic
By clicking the “Apply” button, I understand that my employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Taked
Team Member
Team Member We’re glad you’re here. Think about it – you and us? Sounds like it could be a match made in the meat heavens. If you’re here for: Discounted Curly Fries (and all our menu items for that
Copyright 2023-2025 - www.zdrecruit.com All Rights Reserved