Director of Managed Care Programs - SCO

AgeSpan

About Us: Since 1974 our agency has strived towards supporting an individual's desire to make their own decisions, secure their independence and remain living independently in the community. We are proud of our employees who make this possible every day. Our agency is a thought-leader, a nationally known generator of new ideas, because it welcomes creativity, your ideas. It is an outstanding place to work stimulating, friendly, collaborative. We offer competitive salaries, generous vacation time, and an excellent work/life balance. We value diversity and encourage career growth. If you have a passion for improving the lives of the elderly community and enjoy working in a diverse team driven by its mission, you've found the right place!

At AgeSpan, you'll find a work environment that combines:

• A refreshing culture that is supportive, collaborative, and encouraging of diverse perspectives and backgrounds.
• A focus on innovation with a team recognized for developing and implementing innovative programs and novel solutions.
• Encouragement of your development through opportunities to get involved, use your voice, and gain new knowledge and skills.
• A satisfying balance between your work and personal life, including a flexible workplace, generous paid time off, and wellness programs.

Depending on your role and your hours, we offer

• Flexible schedule and hybrid work opportunities
• Competitive salaries
• Healthcare (medical, dental)
• 403b Retirement Plan with agency match
• 20 Vacation Days, 12 Sick Days, and 12 Paid Holidays
• Social Work Licensing Program
• License Renewal Paid by agency for RN's and Social Workers
• Mileage reimbursement
• Free parking
• Employee Referral Bonuses
• Employee Assistance Program
• Tuition Remission Program
• Agency subsidized gym membership (on-site in Lawrence)
• Commitment to promoting within

Position Responsibilities: Reporting to the Senior Director of Managed Care Programs, the Director of Managed Care Programs- SCO is responsible for the management, supervision, and evaluation of the Senior Care Options (SCO) programs. This position is a member of the Managed Care Leadership team, participating in strategic planning. He/she works within the guidelines, policies, and mission of the agency and will be responsible for specific projects as assigned.

Essential Functions: (Core duties or tasks that are fundamental and not marginal to the performance of the job)

• Provides leadership and direction for the SCO programs within Managed Care
• Point of contact for assigned program(s) and serves as a liaison between AgeSpan, specific managed care plans, other contracted partners, and Mass Health (EOHHS)
• Reports to the Senior Director of Managed Care Programs for supervision, direction and support
• In collaboration with the Senior Director of Managed Care Programs, develops an annual operating plan for specific programs and Managed Care department that supports the agency's strategic plan
• Oversight and implementation of annual operating plan
• Determine yearly caseload analysis and workload analysis to make final recommendations for staffing program growth for annual budget
• Hiring and interviewing for all positions within assigned program(s). Tracking of program(s) and complete necessary paperwork needed for HR
• Collaborates with Fiscal Department regarding billing process for all relevant programs and rectifies claims/ billing issues as they arise
• Reviews and approves of merit for staff and manager annual evaluations. Consults with Senior Director for approval of 2% merit
• Approves DiStefano Fund requests
• Reviews completed Critical Incident Reports and submits with manager
• Oversight of IT initiatives and projects pertaining to the Managed Care Department
• Assures compliance with regulatory requirements of funding source, oversees contract related activities, responds to all inquiries and requests from EOHHS or managed care plans
• Oversees departmental quality assurance and development of quality improvement initiatives including report running, conducting audits, data analysis for trends, improvements and efficiencies. etc.
• Supervises and supports the efforts of the Managed Care Program Managers
• Provides leadership, direction, and motivation for staff on the importance of continuous quality improvement efforts and interdisciplinary team development
• Manages employee relations and community relations as they pertain to assigned programs
• Assures coordination of managed care programs with all programs and services sponsored by the agency
• Participates in state work groups as requested
• Other related duties as assigned

Qualifications: MA/MS in Health Care Administration, Public Health Policy, Nursing or related field with 5 years' progressive leadership experience preferred. Bachelors in related field with 7 years of leadership and management required. Knowledge of the healthcare delivery system and experience in developing and managing new initiatives required. Excellent interpersonal, verbal and written communication, supervisory and computer skills essential.

Hours: 37.5 hours per week

Our Commitment to Diversity and Inclusion

AgeSpan is strongly committed to fostering a professional environment that recognizes, respects, and encourages the unique contributions of a broad spectrum of qualified employees. It is important that our employees reflect the diverse communities we serve. We maintain a work atmosphere that allows people of varied backgrounds to grow professionally and contribute to our mission by promoting diversity, equity, inclusion, and work-life balance.