Program Manager- (Administration) DES

University of Massachusetts Medical School•Westborough, MA

7d•$80,000 - $100,000

About The Position

Under the general supervision of the Director or designee, the DES Program Manager plans and manages a large support unit that provides clinical staff and medical professionals with direct support for disability determinations for client agencies in one or more states, as well as other DES lines of business. The role ensures compliance with DES guidelines and state and federal regulations governing disability determinations and the privacy of protected health information. The Program Manager oversees daily administrative operations, supports existing and new programs, improves administrative systems, and helps establish procedures for new business. The position also oversees customer service operations, quality improvement, staff and human-resource activities, and communication of policy and workflow changes. The role 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; OR 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 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 can provide clinicians with complete, efficient, cost-effective, and timely support for medical and psychological determinations.
Develop and monitor guidelines for staff support of 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 management of unit processes.
In collaboration with administrative managers, direct customer service operations by monitoring call volume, promoting effective telephone skills, developing telephone coverage schedules, reviewing and revising client letters, and monitoring staff performance.
Analyze administrative systems, identify opportunities for improvement and increased efficiency, and implement improvements in coordination with impacted units.
Collaborate 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 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 staffing, recruitment, counseling, compensation, and benefits; ensure personnel actions involving hiring, firing, performance measurement, contracting, and funding are completed.
May serve as liaison with external organizations and other departments.
Adhere to University, State, and funding agency regulations.
Perform related duties as needed and assigned.
Conduct 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.