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GENERAL SUMMARY OF POSITION:

Under the general direction of the Program Director, the Senior Manager is responsible and accountable for all administrative and operational components of the unit, including the supervision of staff, management of day-to-day operations of unit, the development and implementation of policies and procedures related to claiming functions and associated internal controls, revenue projection and reporting and information systems/technology functions related to business needs. The Sr. Manager will oversee Medicaid Administrative claims processing services, Cost Report reconciliation and settlement services, Random Moment Time Study administration, and customer service help desk support services on behalf of contracted clients in multiple states.

MAJOR RESPONSIBILITIES:

• Evaluate and assist in implementing change to increase the efficiency of operations by reviewing reports and information from staffing
• Direct and manage revenue program by monitoring the progress of revenues and analyzing the data and reports
• Perform supervisory functions of hiring, corrective action and employee performance evaluation
• Make recommendations for priorities and program implementations
• Make recommendations for improvements to program operations
• Closely monitor the revenue activities in the assigned unit to insure the regular status of the revenues and report on the potential risks for shortfalls or potential gains
• Develop and implement policy and procedure standards in regards to program monitoring and evaluation
• Oversee and monitor activities of assigned unit
• Work on revenue management projects
• Identify state programs that may be eligible to receive FFP from the Federal Government
• Provide on the job training and orientation for employees
• Develop and implement procedures and guidelines to accomplish project objectives and goals
• Review and analyze data concerning assigned projects in order to determine progress and effectiveness and make recommendations for changes in procedures
• Respond to inquiries from EOHHS staff and others concerning assigned projects
• Perform related duties such as attending staff meetings, maintaining records and preparing reports
• Interact and represent the department on a professional level with EOHHS and other government agencies
• Work individually as well as being a team member
• Work internally and externally to resolve discrepancies for projects
• Perform other duties as assigned.

REQUIRED QUALIFICATIONS:

• Bachelors degree in Finance, Public Administration or Business or equivalent
• 7 years experience in fiscal management, finance or public administration
• Proven skills in financial management or operational management
• Thorough knowledge of funding and revenue sources for health and human service programs
• Thorough knowledge of the federal and Massachusetts state regulations associated with the federal entitlement and block grant programs
• Experience with contract development and management
• Strong management and leadership skills.

Federal financial participation (FFP) is available through Title XIX and Title XXI of the Social Security Act to match expenditures by cities and towns, regional school districts and charter schools (collectively, Local Education Agencies (LEAs)) for the provision of medically necessary medical services provided to Medicaid-enrolled students.  Also eligible for FFP are the LEA costs associated with performing Medicaid administrative activities related to the delivery of services and with performing qualifying outreach activities.  Collectively, this program is referred to as the School-Based Medicaid Program (SBC).

The SBC unit at HCFS works closely with Massachusetts and other states to develop, implement, and manage various activities that support direct service or administrative activity claiming to the Medicaid program.  To that end, SBC develops, maintains, and supports solutions for states to compile, report and review eligible expenditures for Medicaid Administrative Claiming, Direct Service Cost Report Reconciliation and Settlement, Medicaid Eligibility Matching, Random Moment Time Studies or other equivalent allocation methods to support the identification of Medicaid related costs. With a deep knowledge of federal Medicaid regulations, SBC optimizes opportunities, while ensuring compliance with all applicable state and federal rules.   Today, SBC supports over 50,000 users in 10 states for school-based other social service agency Medicaid FFP claiming programs. 

The Sr. Manager for SBC will report to the Program Director.   The Sr. Manager will oversee Medicaid Administrative claims processing services, Cost Report reconciliation and settlement services, Random Moment Time Study administration, and customer service help desk support services on behalf of contracted clients in multiple states.

This position is largely remote but may require occasional onsite work at the Shrewsbury location or in-person attendance at a client meeting, including occasional out-of-state travel. 

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