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Director of Program Development and Grants

BMC HealthNet Plan

Director of Program Development and Grants

Charlestown, MA +1 location
Full Time
Paid
  • Responsibilities

    Reporting to the Vice President of Public Partnerships, the Public Partnerships Manager will be responsible for overseeing compliance with state and federal regulations and contracting.  Primarily overseeing the Senior Care Options (SCO) contract and reporting deliverables, this role will also manage the Plan’s overall relationship with state regulators and other government agencies including the Massachusetts Executive Office of Health and Human Services (EOHHS) and Centers for Medicare and Medicaid Services (CMS).  Additionally, this role will be accountable for working with the Plan’s business units and owners, including the Medicare Product Team, to ensure internal collaboration as well as cross-functional implementation and integration of the SCO contract and regulatory policies and procedures.  Lastly, the Public Partnerships Manager will be charged with overseeing regulatory and contractual compliance for future Medicare products offered by the Plan.

    KEY FUNCTIONS/RESPONSIBILITIES:

    • Serves as the Plan’s key contact and primary liaison with and manages the day-to-day relationship with EOHHS and other state or federal agencies, including Plan responses to requests from EOHHS or CMS.
    • Oversees and ensures the timely completion and quality of deliverables related to contract requirements as well as program and policy changes.
    • Responsible for the collection, analysis, accuracy and submission of all EOHHS and other state and federal based contractual or regulatory reports for SCO (in collaboration with the Pubic Partnerships Senior Reporting Analyst).
    • Leads and coordinates implementation of contract amendments, working with the affected internal business areas.
    • Works in close collaboration with the Medicare Compliance Officer to maintain alignment with CMS and EOHHS requirements and monitors local and national regulatory development, working with Plan business owners, Legal, and Compliance to ensure clear interpretation and timely implementation.
    • Provides contract and regulatory guidance to internal business units to help address and resolve complex program related issues and escalations.
    • In partnership with the Plan’s Medicare Product Team, identifies new opportunities, implement new processes and/or determine needed areas of improvements to existing processes to support optimal program performance and adherence to contractual and regulatory requirements.
    • As directed by the VP or Director of Public Partnerships, supports Plan senior and executive leadership on initiatives and projects related to any Medicare (or Medicaid) programs, expansions, procurements.

    QUALIFICATIONS:

    Education:

    • Bachelor’s Degree in Legal Studies, Health Care Administration, Public Administration, Public Health, Business Administration, Government Relations, Social Sciences or related field. Candidates who do not meet the educational requirement but possess the appropriate combination of experience and training will be considered.Seven or more years of experience in health care/health care insurance organization, managed care, Medicare, Medicaid, or Public Exchange product management.
    • Demonstrated ability to build and lead effective teams and successfully plan, organize and manage initiatives/projects.
    • Experience with data analysis, data interpretation and data driven decision making.

    Experience:

    • Seven or more years of experience in health care/health care insurance organization, managed care, Medicare, Medicaid, or Public Exchange product management.
    • Demonstrated ability to build and lead effective teams and successfully plan, organize and manage initiatives/projects.
    • Experience with data analysis, data interpretation and data driven decision making.

    Preferred:

    • Master’s degree in Health Care Administration, Public Administration, Public Health, Business Administration or Government Relations.
    • Prior experience working on Medicare related or SCO programming.
    • Project management experience.

    Competencies, Skills, and Attributes:

    • Ability to effectively and clearly communicate issues, findings, and recommendation both verbally and in writing to all levels of management, including executive staff, and external stakeholders such as regulatory agencies.
    • Confident taking ownership of work streams with high-level direction and guidance, and producing proposed plans of action in a self-driven manner.
    • Ability to navigate complex, matrixed organizations, with a collaborative approach to problem-solving and performance improvement.
    • Experience managing implementation or performance improvement projects, including producing work plans and managing to them.
    • Strong background in health insurance, Medicaid, Medicare, Affordable Care Act, federal Demonstration programs and managed care.
    • Ability to effectively communicate issues, findings, and recommendations both verbally and in writing to all levels of management, external stakeholders, and regulatory agencies.
    • Ability to build relationships and alliances and successfully to interact within all levels of the organization and external stakeholders.
    • Excellent business writing, proof reading and editing skills.
    • Effective analytical, consulting skills and leadership skills.
    • Strong focus on service to internal and external customers.
    • Ability to prioritize and organize work and to multi-task when required.
    • Ability to work independently and collaboratively, manage multiple projects and meet goals and scheduled deadlines.
    • A strong working knowledge of Microsoft Office products, including Excel and Access.
    • Experience with MS Project and Visio a plus.

    WORKING CONDITIONS AND PHYSICAL EFFORT:

    • Ability to work some extended hours during peak periods

     

    *Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.

    Required Skills Required Experience

  • Qualifications

    • Work with Agency Management staff to develop three-year capital budget and update annually. • Identify, develop, and administer system to prioritize and monitor capital projects. • Ensure all approved Agency projects are identified in the required regional planning documents. • Identify and project annual levels of funding from federal, state, local and agency sources. • Secure federal, state or local funding for projects by preparing and filing all required applications and supporting               documents within the specified time frames. • Negotiate with funding sources for favorable interpretations of rules, regulations and laws in support of agency capital       improvement program. • Prepare and present reports as requested to executive level management. • Prepare for and participate in Agency Board meetings as requested. • Communicate orally and in writing with Agency personnel and management to obtain technical information or                   disseminate grant information. • Develop and maintain strong working relationship with key funding source representatives. • Identify opportunities, develop and administer third-party contracts for local agencies and service providers. • Develop and maintain third-party grant administration relationships and provide technical assistance in all grant related     rules, regulations and laws. • Serve as agency liaison for communication with federal, state and local funding sources. • Develop and implement Agency-wide training on grants procedures and guidelines. • Address issues and problems affecting funding to support agency’s capital improvement program. • Coordinate agency departments to respond to grant related audits and reviews. • Coordinate the grant funding and grant administration processes with the capital budgeting and procurement processes. • Provide effective direction and supervision to department staff. • Ensure grants are completed and closed in a timely manner. • Represent Agency at public forums and meetings. • Communicate and ensure agency compliance with all applicable federal, state and local grant related policies, rules,           regulations and laws and stay abreast of legal, regulatory and policy developments affecting agency. • Coordinate staff to work with departments receiving grant funds. • Encourage staff to develop working relationships to allow for anticipation of funding needs.

  • Locations
    Charlestown, MA • Boston, MA