Program Director - REMOTE

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Program Director - REMOTE Job Number: 2023-45041Category: ManagementLocation: Shrewsbury, MAShift: DayExempt/Non-Exempt: ExemptBusiness Unit: ForHealth ConsultingDepartment: ForHealth Consulting - PPR - W407625Job Type: Full-TimeSalary Grade: 49Num. Openings: 1Post Date: Jan. 9, 2024 GENERAL SUMMARY OF POSITIONThe Health Care Finance Solutions (HCFS) unit provides consulting and operational services to state agencies and public municipalities within the Commonwealth of Massachusetts and nationally, currently serving 18 states. Under the general direction of the Deputy Director of HCFS, the Program Director will manage certain revenue and cost savings programs and functions across state health and human service agencies. Those functions will include directing and managing business operations that identify sources to offset health care costs by maximizing third party benefits and cost sharing opportunities, identifying liable payers, and billing, claiming, and recovering for the costs of health care services in a timely fashion. In addition, the Program Director will lead the development and implementation of new business strategies and operations to meet internal and external client goals and develop and implement new projects and business opportunities.MAJOR RESPONSIBILITIES:Direct and oversee business services, methods and strategies to meet and exceed cost savings and revenue targets for health and human service agenciesLead strategic planning efforts including the development and implementation of departmental performance goals and objectives related to operational and financial management and improvementDirect and lead program enhancement and expansion efforts including the identification of required resources, the implementation of teams; and the assessment of necessary skill sets and competencies to accomplish objectivesManage organizational changeProvide direction and expertise in developing new revenue initiativesProvide business and operational management consulting services to client agencies, HCFS and ForHealth Consulting leadership staffDevelop and maintain effective relationships with internal and external entities to continuously improve the quality and delivery of business services and operations including developing resolutions to issues, incorporating regulatory changes, and exchanging dataOversee, manage and prepare annual expense budgetsDirect the analysis of potential cost savings and revenue projects and business opportunitiesDirect the development of client presentations, proposals, and procurement responsesDirect the development and management of contracts for services and Interagency Service AgreementsAttend federal/national conferences and monitor and assess changing federal/national industry indicatorsEnsure compliance with state and federal rules and regulationsProvide monthly financial and operational reports to client agencies, CHCFS and ForHealth Consulting leadership staffEstablish departmental policies, procedures and objectives, communicate changes to department staff, client agencies, HCFS and ForHealth Consulting staffRecruit, interview, hire, train, and evaluate staffEffectively work in a complex organizational and reporting environmentPreserve confidential information and filesFulfill additional duties as required or requestedREQUIRED QUALIFICATIONS:Masters degree in Finance, Public Health, Human Services Administration, Business Management or equivalent.10-15 years of solid experience and proven skills in financial management or operational management in increasingly responsible management positions, preferably in finance, health and human services.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, leadership, team building, and customer service skills.Superior oral and written communications skills, with strong public speaking ability.ADDITIONAL INFORMATIONAbout the Health Care Finance Solutions and Public Provider ReimbursementThe Health Care Finance Solutions (HCFS) is a part of ForHealth Consulting (ForHealth), the health care consulting division of UMass Medical School, Massachusetts only public medical school. As nationwide leaders in the development and implementation of health care reform, ForHealth and HCFS stay ahead of health care trends and help strategize and plan for changes that impact both health care delivery systems and patients on the local, state and national level.Located in Shrewsbury, MA HCFS helps state agencies identify opportunities to increase savings and reimbursements through federal and other third-party sources, establish effective savings and reimbursement programs, and capitalize on all possible revenue streams. At the same time, we identify opportunities for our clients to increase health care related services, reduce the net cost of delivery, and help ensure individuals receive the health and human service benefits to which they may be entitled.PPR unit at HCFS works closely with state health and human agencies and municipalities to enhance their ability to improve their federal claiming processes, find new revenue opportunities, and coordinate with other payers to capture revenue whenever possible. With a deep knowledge of federal Medicaid regulations, PPR maximizes opportunities, while ensuring compliance with all applicable state and federal rules. PPR provides its clients with comprehensive medical billing and accounts receivable, as well as other services, to maximize the collection of federal, third-party, and private reimbursement for health care and related services provided by public hospitals, mental health clinics, psychiatric hospitals, skilled nursing facilities, and community-based programs. Community-based services include Home and Community-based Waivers, Residential Rehabilitation Option and Targeted Case Management programs. The program produces over $2 billion in gross charges to liable payers and generates over $1.25 million in net revenue. Work Environment: Primarily remote with occasional travel in Massachusetts.UMass Chan Medical School was among 23 companies that stood out as 2023 “DEI champions,” according to The Boston Globe.
Named a U.S. News & World Report“2023 BEST MEDICAL GRAD SCHOOL”for Primary Care and Research
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