POSITION SUMMARY:

Under the general direction of the Director of the MassHealth Quality Office (MQO) in the Office of Clinical Affairs (OCA), or designee, the Quality Program Manager is responsible for managing quality-related activities for MassHealth quality programs.

ESSENTIAL FUNCTIONS:

Quality Program Strategy and Design:

• Collaborate with the Director, or designee, and MassHealth program teams (including the MassHealth Office of Behavioral Health, the MassHealth Office of Long-Term Services and Supports, the MassHealth Office of Provider and Pharmacy Programs, and or the MassHealth Payment and Care Delivery Innovation team) on development of strategy and design of quality programs including for behavioral health providers, Integrated Care Programs, and acute hospitals. Collaborate with MQO leadership and MassHealth program teams to develop program elements including:
  • Selection of quality and health equity measures
  • Setting of performance targets
  • Establishing and testing performance assessment methodologies
  • Maintaining and updating contractual and regulatory documents to accurately reflect quality program design
• Work with MassHealth, MQO, and OCA to ensure that organization-wide quality initiatives are aligned and advancing MassHealth quality strategic goals

Quality Program Implementation & Program Management:

• Act as a subject matter expert on quality improvement, quality measurement, and evaluation.
• Provide consultation and leadership in quality measurement and evaluation to MassHealth and OCA program staff
• Maintain current knowledge of major national quality initiatives and directions related to Medicaid programs
• Establish and maintain linkages within OCA, MassHealth, and other ForHealth Consulting departments to develop and staff quality related projects for the MassHealth organization.
• Provide strategic input and direction for the Quality Office in designing and implementing quality improvement activities for MassHealth quality programs.
• Manage day-to-day logistics and operational needs of the program, convening and providing overall direction to program teams, and identifying and addressing problems which may adversely affect performance of the program
• Coordinate formal communications and meetings among senior program leadership, as well as working with senior departmental management regarding program needs and concern

Quality Stakeholder Engagement:

• At the direction of the MQO director, represent the Quality Office’s work at the state, regional and national levels (research planning, scientific study groups, conferences, and committees).

Cross-Cutting Quality Initiatives:

• Collaborate with a staff of individuals who provide direct support to MassHealth Programs and conduct the activities of the MassHealth Quality Office.
• Hire, advise and directly supervise and evaluate performance of other staff, as applicable. Provide functional supervision of other specific project/program staff as needed
• Review and monitor compliance with the federal and state regulations.
• Perform other duties as required.

REQUIRED QUALIFICATIONS:

• Masters Degree or equivalent in Health Care or Business Administration, Public Health, or a quality related health care field.
• 2-3 years experience with health care quality measurement and performance programs
  Experience with acute hospital, behavioral health, and/or long-term services and supports quality measurement
• Experience working in a matrixed environment
• Demonstrating excellent communication and presentation skills, both oral and written

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