MassHealth Program Manager

Mass General Brigham•Somerville, MA

2d•$63,648 - $92,570•Remote

About The Position

The MassHealth Program Manager supports the day-to-day administration and operations of the MassHealth line of business. Working under leadership guidance, the role coordinates regulatory reporting, operational processes, stakeholder communications, and governance activities to support compliance with contractual requirements and organizational objectives. The position maintains documentation, tracks deliverables and action items, facilitates communication among stakeholders, and assists with MassHealth-related initiatives. It follows established policies, procedures, and priorities, escalating complex issues and recommendations to leadership. The role also supports appeals and claims resolution by helping ensure timely submission and follow-up, gathering documentation, tracking case statuses, and coordinating communications between departments for accurate claims handling. This is a remote, Monday–Friday position with standard Eastern Time business hours. Occasional in-person meetings may be attended by local candidates.

Requirements

Bachelor’s degree required; experience may be considered in lieu of a degree.
At least 3–5 years of experience in project or program management.
Excellent interpersonal and communication skills, including the ability to engage and collaborate with staff at all levels.
Strong project/program management skills, including planning, scheduling, budgeting, and risk management; ability to coordinate and delegate tasks, manage timelines, and drive results.
Strong analytical and problem-solving abilities, with attention to detail and accuracy.
Ability to manage relationships with diverse stakeholders.
Proficiency in Microsoft Office Suite, including SharePoint, Excel, PowerPoint, Teams, and Copilot, and in data management software.
Ability to work collaboratively in a team environment.

Nice To Haves

At least 1–2 years of experience with Medicaid, MassHealth, or government programs.
At least 1–2 years of experience managing reporting processes and compliance workflows.

Responsibilities

Coordinate assigned MassHealth operational activities and initiatives by maintaining timelines, tracking deliverables, documenting progress, and following up with stakeholders.
Prepare, compile, and submit routine MassHealth regulatory reports and contractual deliverables, including quarterly, semi-annual, annual, and ad hoc submissions.
Receive, track, and distribute MassHealth communications; monitor responses and follow-up; and escalate issues requiring management review or decisions.
Coordinate governance, committee, and meeting activities, including scheduling, preparing materials, documenting outcomes, maintaining action-item logs, and supporting follow-up.
Support MassHealth operational processes, including benefit and reimbursement updates, bulletin and transmittal tracking, redetermination activities, member assignment processes, provider enrollment coordination, PIDSL maintenance, practice closure activities, discharge tracking, and related system updates.
Maintain reporting calendars, submission schedules, templates, process documentation, and departmental records to support compliance with contractual requirements.
Assist internal stakeholders with information collection, operational monitoring, and follow-up related to quality, health equity, care management, member experience, provider operations, finance, community partner performance, and MGB ACO initiatives.
Maintain shared resources, systems access, and departmental tools, including OnBase, POSC, Virtual Gateway, SharePoint, Teams sites, reporting libraries, and reference materials.
Produce routine reports, maintain operational data and documentation, and support leadership in monitoring departmental performance and compliance.
Identify operational issues, process gaps, or delays and communicate findings to leadership for review and guidance.
Support appeals and claims resolution by gathering documentation, tracking case statuses, ensuring timely submission and follow-up, and coordinating communications between departments.
Perform other duties as assigned and comply with all policies and standards.