Job description

The MassHealth Office of Long Term Services and Supports (OLTSS) is responsible for managing a robust system of supports for members of all ages who need services to enable them to live with independence and dignity in their daily lives, participate in their communities, and increase their overall quality of life. These services and supports may be provided in the home; in residential, day, and other community-based settings; or in certain facility-based settings, such as nursing homes and chronic disease rehab hospitals.

Within OLTSS, the HCBS Waiver Unit is responsible for oversight of ten 1915(c) Home and Community Based Services (HCBS) Waivers that provide specialized services and supports to especially vulnerable populations.

These waivers are administered by MassHealth and operated by various EOHHS agencies, including the Department of Developmental Services, the Executive Office of Elder Affairs and the Massachusetts Rehabilitation Commission. MassHealth is responsible for ensuring that services provided in any setting and all delivery systems are member-focused, accessible, of the highest quality, and delivered in a cost-effective manner.

The HCBS Waiver Quality Manager supports the Director, HCBS Waiver Administration in oversight of all aspects of quality management and improvement for the HCBS Waiver Unit. These responsibilities entail extensive support and direction to EOHHS agency staff in the development and oversight of quality management strategies compliant with CMS requirements. The HCBS Waiver Quality Manager will provide support, technical assistance and direction to agencies as necessary in order to ensure the quality of such waivers. The successful candidate will develop and maintain a thorough and up-to-date understanding of CMS quality requirements for HCBS waivers and have the ability to effectively communicate this information to a diverse range of state agency staff, advocates and MassHealth members.

There is exciting work underway at the national level on quality measurement for Medicaid LTSS programs, with the development of a national set of performance measures. The HCBS Quality Manager will be responsible for tracking this work, gathering feedback, and participating in national discussions. There are opportunities at the state level to develop a cohesive quality framework for LTSS, and the HCBS Quality Manager will play an important role in that strategic work.

Duties and Responsibilities (these duties are a general summary and not all inclusive):

The HCBS Waiver Quality Manager will support the Director, HCBS Waiver Administration in oversight of all aspects of quality management and improvement for the HCBS Waiver Unit. Duties will include but not be limited to:

Provide ongoing oversight of quality management and reporting conducted by the operating agencies for the state’s Home and Community Based Services Waivers, including:
Develop quality management reporting schedules and requirements for operating agencies and support the operating agencies to maintain those schedules.
Review and analyze quality reports received from operating agencies; identify issues and escalate to Director and Deputy Director.
Provide technical assistance to operating agency staff.
Work with operating agencies to update quality oversight measures and processes, working to continually improve measures and quality information.

Serve as quality expert for HCBS Waiver Unit, including:
Develop and maintain a thorough understanding of waiver program quality/performance measure requirements, best practices, and innovations in quality oversight for community LTSS.
Track, identify and communicate changes in CMS policies and requirements related to HCBS waiver quality oversight, verbally and in writing, to internal staff and operating agencies.
Gather, review and disseminate data/reports for oversight of waiver program operations.
Serve as liaison to the UMass Office of Clinical Affairs and participate in development of overarching MassHealth quality strategy, particularly as relates to community LTSS. Provide linkage and promote alignment between Waiver Unit and broader quality initiatives.
Provide guidance and support to waiver data analyst in collection of data and design of report parameters.
Support the Director/Deputy Director in managing relationship with MassHealth contractors to ensure appropriate implementation of contract requirements and ensure high quality clinical assessment and appropriate service delivery for waiver applicants/participants.
Coordinate with waiver operating agencies in managing compliance with CMS Community Rule, including updating Statewide Transition Plan as necessary, tracking progress on STP milestone completion and conducting public input activities as required.
Respond to audit requests, including providing guidance to staff, collection and review of requested materials in response to audit requests and communicating with MassHealth Program Integrity staff and auditors.
Coordinate waiver team response to external surveys related to HCBS, such as the annual Kaiser Budget and/or HCBS survey, etc. and be responsible for development of all survey responses, providing draft information to Director/Deputy Director prior to submission.

Support development of new HCBS waiver programs, waiver amendments and renewals:
Assist in development and drafting of waiver renewal applications and amendments, with particular focus on sections of the application related to quality management.
Conduct project management, including developing work plans, facilitating workgroups and coordinating workgroup assignments.
Develop/draft waiver applications using web-based waiver template.
Interact with appropriate staff to support the implementation of new policy and program initiatives, changes to current policies and procedures, and in support of waiver implementation.

Support HCBS waiver operations and communicate HCBS waiver information:
Assist in coordination of public input processes for waiver actions, including development of public notices, coordinating with MassHealth Publications staff, tracking and analyzing feedback received and recommending changes based on input.
Support development of program requirements and/or regulations; organize, chair, and facilitate workgroups and meetings; prepare or contribute to required reports; research, consolidate and synthesize information on specific topics as assigned. Contribute to development of procurements, contractual language and ISAs in support of HCBS waiver implementation. Monitor contracts and vendors, oversee their performance, and determine need for and recommend any corrective action, as appropriate.
Support Director in on-going administrative, management and training activities, policy development and implementation and other duties as assigned.

Preferred Qualifications:

• Master’s degree in public policy/administration, health administration, social services, business, law degree or graduate degree in a related field.
• Minimum 5 years full time, or equivalent part-time, supervisory or managerial experience in business administration, business management, health care or human services administration, or public administration
• Ability to analyze data in order to draw conclusions and make data driven recommendations; ability to prepare charts, graphs and tables; and experience presenting that information in Microsoft Word and PowerPoint.
• Experience utilizing data to understand patterns and trends and preparing clear and concise reports summarizing that information.
• Experience working with large databases, forecasting expenditures, and analyzing data sets using Microsoft Excel and other Microsoft applications.
• Project management experience strongly preferred.
• Excellent written and oral communications skills, including ability to write clearly and concisely, and to communicate effectively.
• Ability to understand, explain, and apply laws, rules, regulations, policies, procedures, and to collaborate with both internal and external parties in such work.
• Ability to develop, implement and monitor contracts and ISAs.
• Knowledge of and experience with Medicaid programs, and CMS rules, programs, regulations, etc.
• Experience organizing and managing external stakeholder groups and coalitions.
• Ability to establish rapport with others, and to establish and maintain harmonious working relationships with others.
• Strong attention to detail and the ability to maintain a high level of data accuracy and consistency.
• Ability to manage time, set priorities, and work under time constraints.
• Ability to manage multiple projects with competing deadlines and adapt to changing deadlines.
• Ability to exercise sound judgment.
• Ability to exercise discretion in handling confidential information.

TO APPLY:

Please upload both Resume and Cover Letter for this position when applying.

About MASSHEALTH:

The mission of MassHealth is to improve the health outcomes of our diverse members, their families and their communities by providing access to integrated health care services that sustainably promote health, well-being, independence and quality of life. For more information about our agency and programs please visit: www.mass.gov/masshealth

A criminal and tax history 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/coriand click on "Information for Job Applicants."

As part of the hiring process, the Office of Human Resources will be verifying any college-level degrees conferred to the selected candidate. Additionally, any licensure required for the position will be verified. Information provided as part of the hiring process is subject to the Massachusetts Public Record Law and may be published on the Commonwealth’s website.

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 contact the Executive Office of Health and Human Services Human Resources Department at 1-800-510-4122 and select option #2.

Qualifications - External

MINIMUM ENTRANCE REQUIREMENTS:

Applicants must have at least (A) five (5) years of full-time or, equivalent part-time, professional, administrative, supervisory, or managerial experience in business administration, business management, public administration, public management, clinical administration or clinical management of which (B) at least one (1) year must have been in a project management, supervisory or managerial capacity or (C) 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 (A) experience.

II. A Bachelor’s degree in a related field may be substituted for two (2) years of the required (A) experience.

III. A Graduate degree in a related field may be substituted for three (3) years of the required (A) experience.

IV. A Doctorate degree in a related field may be substituted for four (4) years of the required (A) 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!

Executive Order #595: As a condition of employment, successful applicants will be required to have received COVID-19 vaccination or an approved exemption as of their start date. Details relating to demonstrating compliance with this requirement will be provided to applicants selected for employment. Applicants who receive an offer of employment who can provide documentation that the vaccine is medically contraindicated or who object to vaccination due to a sincerely held religious belief may make a request for exemption.

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 Type: Full-time

Pay: $90,000.00 - $100,000.00 per year

Benefits:

• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Professional development assistance
• Referral program
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to commute/relocate:

• Boston, MA 02108: Reliably commute or planning to relocate before starting work (Preferred)

Application Question(s):

• Are you familiar with Medicare and Medicaid in a professional sense?
• Are you familiar with the Federal rules and requirements for community based programs?
• How many years of experience do you have in human services?

Experience:

• Supervisory: 5 years (Preferred)
• Quality analytics: 5 years (Preferred)
• Data analytics: 5 years (Preferred)
• Training: 5 years (Preferred)

Work Location: Hybrid remote in Boston, MA 02108

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