Provider and Claims Operations Coordinator Job at EO of HHS PayRoll/Gen Admin
GENERAL SUMMARY OF POSITION:
This position will report to the Director of Provider Operations. This position will support the Directors of Provider and Claims Operations as well as other internal and external stakeholders such as EOHHS staff, providers, and vendors in the development, implementation, and ongoing activities that support the MassHealth provider experience and overall goals and objectives of MassHealth.
GENERAL STATEMENT OF DUTIES AND RESPONSIBILITIES:
This position will assist the Directors of Provider and Claims Operations in the support of the MassHealth Business Support Services (BSS) contract and the Customer Service Center contract.
Areas of focus will be developing and analyzing various reports that will gauge the effectiveness and quality of activities performed by our MassHealth contracts as well as satisfaction of Providers and internal stakeholders. Assessing and supporting provider escalations and resolutions. Participating in the implementation of new MassHealth programs and the updating of current program policies and procedures. Participate in internal workgroups that support Provider and Claims Operations activities.
Duties and Responsibilities (these duties are a general summary and not all inclusive):
- Assist in establishing and maintaining relationships with our vendors, EOHHS staff and the MassHealth Provider community.
- Support BSS and Customer Service Center contracts by evaluating vendor reports, provider call experiences to determine trends, quality improvements, and overall provider experience.
- Participate in internal workgroups representing Operations subject matter expertise.
- Ability to create long and short-term plans that include, setting targets and adhering to deadlines.
- Assign and monitor projects and tasks assigned to internal and external parties
Preferred Qualifications:
- Ability to communicate effectively in oral expression and provide written and oral instructions
- Ability to analyze and determine the applicability of data, to draw conclusions, and make recommendations
- Knowledge of methods used in the preparation of charts, graphs, dashboards, and tables
- Experience with project plans
- Ability to successfully execute many complex tasks simultaneously
- Ability to adjust to varying or changing situations
- Strong proficiency in computer programs including; Microsoft office, word, excel, and Teams
- Proficient in analytic, interpersonal, and leadership skills
TO APPLY:
Please upload both Resume and Cover Letter for this position when applying. First consideration will be given to those applicants that apply within the first 14 days.
About MASSHEALTH:
To improve the health outcomes of our diverse members and their families by providing access to integrated health care services that promote sustainable & equitable health, well-being, independence and quality of life.
For more information about our agency and programs please visit: www.mass.gov/masshealth
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, please the contact the Office of Human Resources at 1-800-510-4122 and select option #2.
- Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed.
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!
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