GENERAL SUMMARY OF POSITION: 

The Public Provider Reimbursement (PPR) Department within the Center for Health Care Finance Solutions conducts statewide business services for several health and human services agencies of the Executive Office of Health and Human Services (EOHHS) to maximize revenue for the Commonwealth of Massachusetts.  Revenue is obtained from private, state and federal resources to reimburse the Commonwealth for the costs of health care and related services provided by public institutions and community-based programs.  The PPR Supervisor is responsible for managing day-to-day business services and operations including medical billing and health insurance identification and access activities, and supervising, training and evaluating staff.

MAJOR RESPONSIBILITIES:

• Supervise and train staff and participate on hiring and performance evaluation activities.
• Conduct individual supervisory meetings regularly with staff including meeting quarterly to review goals.
• Oversee and manage day-to-day business services and operations of program areas ensuring the provision of professional customer service.
• Direct and manage medical billing, claiming activities and monitor outstanding accounts receivables.
• Direct and manage activities to identify, coordinate and maintain access to health care coverage and related benefits.
• Direct and manage broad spectrum of business services or specific services and focused activities.
• Review and analyze data, maintain and update spreadsheets, databases and systems and resolve discrepancies.
• Oversee and manage Internal Control Reviews.
• Provide internal and external customers with professional customer service including responding to and following up on inquiries.
• Write, review, prepare and maintain business documents including reports, contracts, manuals, procedures and presentations.
• Participate in professional training and cross-training activities to enhance performance and skills.
• Participate in continuous quality improvement initiatives and projects.
• Foster compliance with state and federal rules and regulations.
• Work independently and as a team member and leader.
• Preserve confidential, protected health and personally identifiable information and files.
• Fulfill additional duties and special projects as required.

REQUIRED QUALIFICATIONS:

• Bachelor’s degree or equivalent related experience.
• 4 years of related experience
• Knowledge of state and federal health care programs and benefits.
• Excellent customer service and written and verbal communication skills.
• Proven ability to prioritize and coordinate multiple tasks and meet deadlines
• Solid skills with database and spreadsheet management and applications such as Microsoft Office Excel, Word, Teams and One Drive.
• Ability to adapt and change direction in response to changes in the business environment.

PREFERRED QUALIFICATIONS:

• Supervisory experience
• Medical billing or health care insurance experience
• Knowledge of state and federal rules and regulations related to health care finance
• Experience with state and federal information systems such as Meditech, MA21, MMIS and MMARS

PPR produces over one billion in gross charges to liable payers and generates over $700 million in net revenue to the Commonwealth.  PPR conducts various business services statewide for 12 health and human services agencies and more than 20 public facilities that include hospitals, mental health centers and clinics, intermediate care and skilled nursing facilities, and various community-based services.  Community-based services include Home and Community-based Waivers, Residential Rehabilitation Option and Targeted Case Management programs.  The PPR Supervisor will work closely with PPR staff and collaborate with the staff of EOHHS health and human services agencies that may include the Department of Developmental Services, Department of Mental Health, the Department of Public Health, the Department of Youth Services, the Division of Health Care Finance and Policy, the Executive Office of Elder Affairs, the Massachusetts Commission for the Blind, the Massachusetts Commission for the Deaf and Hard of Hearing, the Massachusetts Rehabilitation Commission, the Office of Medicaid, and the Chelsea and Holyoke Soldiers’ Homes.

-  PPR Supervisor oversees revenue claiming for the Southeast region of the Department of Mental Health (DMH) and supervises 7 staff.  The office is located at Taunton State Hospital.

- This DMH SE region covers 7 DMH facilities and several community programs (residential, targeted case management, intensive supports etc)

-  Hybrid position - some work at home and in office work.  Split to be determined at time of hire.

-  Occasional travel to meetings may be required as safety allows.

-  COVID vaccine and booster required.