Deputy Director Program Integrity

Commonwealth of Massachusetts • Boston, MA

10h • Hybrid

About The Position

MassHealth is the Medicaid and CHIP plan for Massachusetts, providing access to healthcare services to approximately 2 million low-income and disabled residents of the Commonwealth. MassHealth is responsible for a ~$22 billion annual budget comprised of insurance premiums, payments for healthcare services, payments for pharmaceutical therapies, administrative expenses, and more.
The Program Integrity Unit is a highly strategic function within MassHealth that sets the standard for financial stewardship. Program Integrity leads and coordinates efforts related to identifying, preventing and mitigating fraud, waste and abuse (FWA) across the MassHealth program and ensuring Commonwealth resources are utilized appropriately in support of MassHealth members. The team is led by the Director of Program Integrity, who reports to the Deputy Medicaid Director, and consists of 13 internal staff members and dozens of contractors ($50M+ in annual contract value). MassHealth currently works in a hybrid in-person and virtual environment, with headquarters located in downtown Boston.
MassHealth is seeking qualified applicants for the position of Deputy Director of Program Integrity. Reporting to the Director of Program Integrity, the Deputy Director will play a vital role in the design and alignment of program integrity strategic priorities and directly manage projects with high visibility and significant policy and financial impact. The Deputy Director will be expected to maintain a broad strategic view across program integrity teams and build strong relationships across the MassHealth functional areas, across EOHHS, and with interagency partners, in order to influence outcomes and maintain momentum of initiatives. In this role, the Deputy Director will convene cross-functional teams including representatives from program teams, policy, strategy, and legal to execute key strategic initiatives. The Deputy Director will also manage MassHealth program integrity external communications including developing inputs for formal responses to external stakeholders.
The Deputy Director will also support the Director in achieving operational excellence across the program integrity unit. The Deputy Director will help lead the development of professional development initiatives for staff and support the Director in hiring and recruitment efforts. The Deputy Director will provide project management support on key projects on behalf of the Director, including procurements and other priority initiatives. Finally, the Deputy Director will be responsible for measuring success across the Program Integrity Unit both in terms of financial savings as well as operational measures that demonstrate effectiveness and efficiency of program integrity processes.
Program integrity is a top priority for MassHealth and EOHHS, and this role will drive key initiatives that directly serve that priority; as a result, the Deputy Director will have regular exposure to MassHealth and EOHHS senior leadership.

Requirements

• Applicants must have at least (A) six (6) 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 two (2) years must have been in a project management, supervisory or managerial capacity or (C) any equivalent combination of the required experience and substitutions below.
• 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.

Nice To Haves

• Excellent analytical and problem-solving skills.
• Excellent MS Excel and PowerPoint skills.
• Excellent communication skills.
• Entrepreneurial mindset; ability to identify opportunities and develop solutions with minimal guidance.
• Experience analyzing large data sets and/or overseeing analytics teams.
• Ability to work effectively under high pressure and tight deadlines.
• Ability to provide structure and process management to projects.
• Strong interpersonal skills.
• Experience in healthcare strongly preferred.
• Knowledge of CMS and MassHealth regulations, preferred.
• Experience with claims data or other related analytical experience strongly preferred.
• Demonstrated performance in strategic planning and analysis.
• Experience leading high-profile projects and processes with accountability to senior leadership.

Responsibilities

• Provide thoughtful leadership, direction and execution for cross-functional, organization-wide strategic program integrity projects; convene key stakeholders and help drive decisions and/or successful execution; identify opportunities to engage with other agencies/external stakeholders and cultivate collaborative processes.
• Lead special projects, time-sensitive requests from leadership, and provide general support and back up to the Program Integrity Director as directed.
• Build operational excellence, including development, maintenance, and implementation of work plans and standard operating procedures for key program integrity initiatives.
• Manage internal and external communications directing development and/or draft materials for external communication including reports, talking points, and presentations, in collaboration with other program integrity and MassHealth colleagues.
• Maintain existing financial savings tracking processes and develop new metrics to measure program integrity operational effectiveness.
• Support recruitment of staff and the hiring process and lead efforts to identify opportunities for staff development within Program Integrity. Develop formal and informal opportunities for skill-building and collaborative learning.

Benefits

• Comprehensive Benefits
• outstanding suite of employee benefits that add to the overall value of your compensation package.
• work experience that supports you, your loved ones, and your future.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees