GENERAL SUMMARY OF POSITION:  Under the general supervision of the Associate Director, or designee, the Clinical Reviewer II is responsible for completing Pre-Admission Screening Resident Reviews (PASSR) Level II Evaluations by conducting face to face evaluations and reviewing medical records, in accordance with relevant guidelines and regulations. This position ensures that individuals with mental illness (MI), seeking admission to or currently residing in a nursing facility, receive an in-person evaluation and nursing facility placement determination. 

GENERAL SUMMARY OF POSITION:  Under the general supervision of the Associate Director, or designee, the Clinical Reviewer II is responsible for completing Pre-Admission Screening Resident Reviews (PASSR) Level II Evaluations by conducting face to face evaluations and reviewing medical records, in accordance with relevant guidelines and regulations. This position ensures that individuals with mental illness (MI), seeking admission to or currently residing in a nursing facility, receive an in-person evaluation and nursing facility placement determination. 

GENERAL SUMMARY OF POSITION: Working as a member of the Medicare Eligibility Enhancement Programs Team at Health Care Finance Solutions (HCFS), the Medicare Savings Program Manager is responsible and accountable for oversight of all day-to-day operations of the Medicare Savings Program (MSP) Unit. The MSP Unit is responsible for administering the Medicare Savings Program on behalf of MassHealth and the Massachusetts Executive Office of Health and Human Services. Under the direction of the Director or designee, the primary responsibilities of the Manager include the implementation and management of MSP policies and procedures, program reporting, enhancement of current program operations and supervision of program staff. The...

Under the direction of the Executive Director, Workplace Equity & Inclusion or Designee, the Applied Public Policy Scholarly Project Graduate Internship Program is a collaboration between ForHealth Consulting at UMass Chan Medical School and Massachusetts’ Medicaid agency (MassHealth). The program offers a unique opportunity for currently enrolled master’s students or Doctoral students or candidates to participate in a scholarly project aligned with their academic calendar, program requirements, and the needs identified by MassHealth.  

POSITION SUMMARY:   The Advisor is responsible for reviewing medical records, constructing functional capacity reports and deciding of disability for applicants seeking benefits based on disability.  Advisors provide clinical guidance to staff.  Advisors oversee the quality of reports and documentation produced by their peers and determine quality improvement initiatives as appropriate. Advisors shall obtain sign-off from a physician on decisions; when necessary.  

POSITION SUMMARY: Under the general supervision of the Clinical Manager or designee, this position provides direct administrative support and services necessary for the completion of professional medical responsibilities and functions for DES’ skilled professional medical personnel (SPMP), i.e. DES Physician and Psychologist Advisors, Disability and Appeals Reviewers, Program Managers and the Clinical Manager. The Disability Assistant makes complex decisions regarding protected healthcare information, based on the Federal Health Information Portability and Accountability Act of 1996 (HIPAA).  This position is responsible for exercising judgment on all administrative and clerical aspects of the case in...

POSITION SUMMARY: Under the general supervision of the Clinical Manager or designee, this position provides direct administrative support and services necessary for the completion of professional medical responsibilities and functions for DES’ skilled professional medical personnel (SPMP), i.e. DES Physician and Psychologist Advisors, Disability and Appeals Reviewers, Program Managers and the Clinical Manager. The Disability Assistant makes complex decisions regarding protected healthcare information, based on the Federal Health Information Portability and Accountability Act of 1996 (HIPAA).  This position is responsible for exercising judgment on all administrative and clerical aspects of the case in...

POSITION SUMMARY:  Under the general supervision of the Associate Director, or designee, the Nurse Reviewer II is responsible for providing administrative case management as part of the Community Case Management Program. This position is responsible for the authorization, coordination and facilitation of community long term care services for program Members. As a member of a multidisciplinary team, the Nurse Reviewer II is responsible for assessing, planning, organizing, reviewing and evaluating the care needs of Members requiring community based services. This position fosters and promotes continuity of care and cooperative partnerships by liaising with nursing providers, state agency staff, acute care hospitals...

GENERAL SUMMARY OF POSITION: Under the general direction of the Director or designee, the Sr. Healthcare Data Analyst needs to be insightful, detail-oriented professional with excellent analytical skills who is able to apply that skill set to data analysis, data mining and data management within a medically-oriented, dynamic analytic team.

Under the general supervision of the Operations Manager, this position is responsible for the initial review and processing of all incoming and outgoing written and electronic correspondence, records, disability supplements, medical information, and related materials.   This position provides the primary mailing, receipt, review, and customer service functions for disability supplements (Mass Health or other agencies). Decisions made in this area directly impact the time line for the disability review process and for the determination of benefits for Mass Health and other agency applicants. Staff has frequent interaction with applicants, their representatives, hospitals and other...

POSITION SUMMARY:  Under the general supervision of the Associate Director, or designee, the Nurse Reviewer II is responsible for providing administrative case management as part of the Community Case Management Program. This position is responsible for the authorization, coordination and facilitation of community long term care services for program Members. As a member of a multidisciplinary team, the Nurse Reviewer II is responsible for assessing, planning, organizing, reviewing and evaluating the care needs of Members requiring community based services. This position fosters and promotes continuity of care and cooperative partnerships by liaising with nursing providers, state agency staff, acute care hospitals...

Under the general direction of the Director or designee, the Sr. Research and Evaluation Analyst provides high-level and diverse project support and coordination of project activities on multiple projects undertaken with external client organizations. The Sr. Research and Evaluation Analyst will assist the Director in leading and documenting project activities and may lead sub-components of a project.  The Sr. Research and Evaluation Analyst will develop and implement projects while adhering to UMMS's Project Management guidelines.

The Deputy Managing Director (DMD) of Operations will oversee the management and operations within the Digital Solutions department as well as the technological infrastructure and strategic platform architecture.   1) The DMD is responsible for the day-to-day operations of digital health solutions, ensuring the smooth and coordinated delivery of programs and services. The role has oversight as assigned by the MD in the following areas: strategy, finance, human resources, portfolio and project management, asset and vendor management and compliance with state...

Under the general direction of the Project Lead/Principal Investigator or designee, the Research & Evaluation Associate manages the day-to-day operations of short term and multi-year research and/or evaluation projects. The Research & Evaluation Associate is responsible for the implementation of research/evaluation projects from inception to completion and manages and coordinates these activities.

The Deputy Managing Director (DMD) of Technology will oversee the technological infrastructure and strategic platform architecture within the Digital Solutions department - The DMD is responsible for the day-to-day operations of digital health technology services, and will manage solution engineering, data design, testing, and integration while ensuring alignment with operations and information security protocols. - The role has responsibilities, as...

GENERAL SUMMARY OF POSITION:  Under the direct supervision of the assigned manager, the High School Intern is responsible for basic tasks to support a designated department.  These tasks may be administrative or research oriented, depending on the department.  For research-based departments, the High School Intern will be responsible for basic laboratory tasks.   Specific job responsibilities will vary by department but may include information gathering, data entry, writing, editing and/or laboratory work.  This is a temporary, non-benefitted role.

POSITION SUMMARY:  The Deputy Executive Vice Chancellor, Chief Human Resources Officer (CHRO) is responsible for developing and executing the UMass Chan human resources strategy and operations in support of the UMass Chan mission, business plan and strategic direction of the organization. The CHRO will focus on building an entrepreneurial and innovative organizational culture that is aligned with the campus mission and strategic plan; that emphasizes organizational learning; and is characterized by an agile, service-oriented, diverse, collaborative, high performing, professionally competent, engaged and accountable workforce. The CHRO will articulate UMass Chan...

POSITION SUMMARY:  Under the general direction of the Associate Director or the Clinical Leader or designee, the Nurse Reviewer is responsible for medical necessity determinations of provider-requested services (prior authorization requests) consistent with established procedural standards and MassHealth program rules and regulations. 

This requisition is being used as a sourcing tool and does not have an open vacancy. Your application to this req will add you to a pool of candidates for potential future openings. We still encourage you to apply directly to positions you feel best meet your background, as this will not replace your application for other openings.    Under the direct supervision of the Director or designee, the Pharmacy Associate I will function as a team member for the client programs within Clinical Pharmacy Services (CPS). CPS is responsible for...

POSITION SUMMARY:  Under the general supervision of the Manager/Department Head or designee, the Administrative Assistant II coordinates and performs a variety of confidential and complex administrative duties independently with minimal direction.