Program Manager- (Administration) DES

University of Massachusetts Medical School•Westborough, MA

About The Position

Under the general supervision of the Director or designee, the DES Program Manager plans and manages a large support unit. The unit provides clinical staff and medical professionals with direct support for activities needed to complete disability determinations for client agencies in one or more states, as well as for other lines of business DES may develop. The Program Manager ensures compliance with DES guidelines and state and federal regulations governing disability determinations and the privacy of protected health information. The role manages day-to-day administrative operations, develops and monitors support guidelines, oversees DES programs and processes, and helps establish administrative and clinical-support procedures for new business. It also directs customer service operations, evaluates and improves administrative systems, supports staffing and human-resource activities, and promotes quality improvement, privacy, and data security. The Program Manager may serve as a liaison with external organizations and other departments and performs related duties as assigned.

Requirements

Current, unrestricted Registered Professional Nurse (RN) license and six years of relevant experience, or equivalent clinical licensure and experience.
Alternatively, a master’s-prepared, licensed or certified vocational rehabilitation counselor or other licensed or certified allied health professional with three years of relevant experience in medical and/or psychological fields, including two years of specific medical training.

Nice To Haves

Supervisory experience overseeing staff and processes, including staff supporting physicians’ and psychologists’ clinical functions.
Office-management or other administrative experience with specific knowledge of customer service, computer report preparation, and quality improvement.
Experience in process improvement or other quality-improvement activities.
Demonstrated oral and written communication skills for interacting with clients, agency partners, and staff.
Experience using computer-based tools, including email, word processing, database management, spreadsheets, and graphics.
Understanding of state and federal laws and regulations related to disability or disability determination.
Understanding of state and federal laws and regulations related to privacy and security of protected health information and data in a medical setting.

Responsibilities

Manage the unit’s day-to-day administrative operations so staff provide clinicians with the support needed for complete, efficient, cost-effective, and timely determinations.
Develop and monitor guidelines for staff supporting medical and psychology professionals in the disability review process.
Manage DES programs related to the unit’s functions and processes, and provide input during program initiation or renewal.
Provide administrative support for existing and new DES lines of business through effective unit-process management.
Direct customer service operations in collaboration with administrative managers, including monitoring call volume, promoting effective telephone skills, developing coverage schedules, reviewing and revising client letters, and monitoring customer-service performance.
Analyze administrative systems, identify opportunities for improvement and increased efficiency, and implement improvements in coordination with impacted units.
Work with DES Senior Management to analyze clinical-support and administrative resources for new business opportunities and establish procedures for new programs.
Develop and monitor guidelines for determinations that do not require clinical decisions.
Promote continuous quality improvement and staff participation in quality-improvement workgroups within the unit and with other DES units.
Promote protection of health information through knowledge of HIPAA and other privacy and data-security laws, staff education, and training.
Coordinate data-security issues and training with the DES Compliance Liaison and the ForHealth Consulting Office of Compliance and Review.
Oversee and provide human-resource support for unit staffing, recruitment, counseling, compensation, and benefits.
Ensure personnel actions related to hiring, firing, performance measurement, contracting, and funding are completed.
Serve as a liaison with external organizations and other departments as needed.
Adhere to University, State, and funding-agency regulations.
Perform quality-assurance reviews of administrative staff and report findings and trends to the Associate Director of Clinical Operations or designee.
Communicate and implement policy, workflow, and organizational changes to direct reports.
Perform related duties as needed and assigned.