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Sr Manager, TPL Programs - Enhanced Coordination of Benefits (ECOB) Program

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Job Details

Overview

Under the general direction of the Associate Program Director or designee, the Sr Manager, TPL (Third Party Liability) Programs is responsible and accountable for managing TPL program areas, operations, and activities. TPL refers to the legal obligation of third parties, including but not limited to, certain individuals, entities, insurers, or programs to pay part or all of the expenditures for medical assistance furnished under a Medicaid state plan. By law, all other available third party resources must meet their legal obligation to pay prior to the Medicaid program paying for the care of an individual, when there is the potential of another liable entity. This position is specifically responsible for operational, program, and contract management oversight of TPL programs and activities. In addition, is responsible for daily operations management of the unit and staff, which provides TPL and coordination of benefits services to MassHealth, the Massachusetts Medicaid program, to ensure that MassHealth is the payor of last resort.

Responsibilities

• Lead and manage TPL programs, operations, and activities, and assist in the implementation of strategic goals and objectives.• Oversee and monitor activities of assigned unit.• Monitor operational efficiencies, and financial outcomes, metrics and benchmarks to provide continuity and ensure program operational success.• Make recommendations for priorities and program implementations.• Make recommendations for improvements to program operations.• Closely monitor the cost savings and revenue activities in the assigned unit to ensure the regular status of the cost avoidance and revenue targets and report on the potential risks for shortfalls or potential gains.• Develop and implement policy, procedure, and program tracking standards in regards to program monitoring and evaluation.• Evaluate and assist in implementing change and ongoing process improvements to increase the efficiency of operations and programs.• Work on TPL cost savings and revenue management projects.• 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.• Perform related duties such as attending staff meetings, maintaining records, and preparing reports.• Interact and represent the department on a professional level with the Massachusetts Executive Office of Health and Human Services (EOHHS) and other government agencies. Respond to internal and external entities concerning assigned projects.• Work internally and externally to resolve discrepancies for projects.• Perform other duties as assigned.

Qualifications

REQUIRED EDUCATIONBachelor’s degree in Finance, Public or Health Care Administration, Business, or other related area.REQUIRED WORK EXPERIENCE7 – 9 years of experience in health and human services program management, fiscal management, finance, or public administrationProven skills in financial management or operational management.Thorough knowledge of the federal and Massachusetts state regulations associated with TPL program activities.Thorough knowledge of cost savings and revenue sources for health and human service programs.Experience with contract development and management.Working knowledge of Microsoft Office applications and database management.Strong management and leadership skills.

Organization

Realize Your Opportunities – A Career at UMASS Medical School

Inside Workings at UMASS Medical School

The University of Massachusetts Medical School (UMMS), the Commonwealth's only public medical school, is proud of our role in serving the people of Massachusetts. Although, its the inside workings of UMMS that makes the difference.

Mission and Culture

  • We’re serious about our mission and about our people. 
  • Real World Impact - Our people get excited about our mission of real-world impact in health sciences education, research and public service.
  • International Prominence and New Opportunities - As this institution has grown to national – and international – prominence, we’ve found new opportunities to train tomorrow’s physicians, nurses and scientists,  discover causes of and cures for disease and help improve the quality of health care.
  • Deep Commitment - With our clinical partner, UMass Memorial Health Care, and our other teaching affiliates, we share a deep commitment to national distinction in patient care.
  • Valued Partnerships – UMMS partners with Commonwealth Medicine, the health care consulting arm of UMMS. Also, UMMS partners with MassBiologics in scientific collaborations, technology management and creating partnerships for the development of products for the benefit of patients.  These valued partnerships help us to provide services and programs to help meet our needs at UMMS and the public.
  • Proud Contributors - People at UMMS enjoy the feeling of going to work every day knowing what they do is truly important and worthwhile.
  • Complementary and Inseparable - These varied parts of our mission and culture are complementary and inseparable.                 

Careers

UMMS, the state’s first and only public academic health sciences center, educates physicians, scientists and advanced practice nurses to heal, discover, teach and care, with compassion.  UMMS is a world-class institution with opportunities to match. 

Competitive Compensation – UMMS offers salaries that are competitive with Worcester-area employers. When combined with our generous benefits, perks, and paid time off, many job seekers are surprised to find a total rewards package that matches or exceeds their current situation.

Targeted Hiring Process – At UMMS, there are actually multiple hiring processes for different segments of our workforce.  In nearly all cases, UMMS hiring process is decentralized, with qualified candidates screened and referred to an academic officer or manager with hiring authority.

24/7 Access to Employment Opportunities – iCIMS is our online job search and application system.  iCIMS is available 24/7 to provide you with a convenient and up-to-date view of the available employment opportunities across our campuses. Updates are made daily and include all faculty and non-faculty position listings from every school and department within the UMMS. When you identify a position you are interested in and qualified for, apply online. New opportunities become available frequently so it pays to check back often!

Benefits

With outstanding benefits, competitive pay, extensive learning opportunities, and a stimulating and attractive work environment, UMMS may be exactly the employer you’ve been looking for.

• Superior Benefits - UMMS offers a wide range of benefits and perks that invite comparison with the best employers in the Worcester area – and with academic institutions anywhere. UMMS provides superior medical and dental coverage for you and your family, fully funded retirement plans, generous time off, a Tuition Assistance Plan – and much more.

• People Centered - UMMS is an employer, but it is also a community. Its comprehensive medical and dental benefits, retirement plans, and even paid holidays reflect an institution built around people, with a deep respect for their differences and needs.

• Commitment to Healthy Living - UMMS provides resources to help you balance work and life and encourages healthy living through great programs and discounts for fitness, physical activity, weight management, nutritional counseling and general wellness available through our health insurance plans.

• Breadth of Offerings - Above all, the breadth of UMMS offerings set the School apart and makes it an environment favored by all sorts of smart, career-savvy people.

Apply for a Job

As an equal opportunity and affirmative action employer, UMMS recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds.

Online - To view all job opportunities and apply online, visit www.umassmed.edu/hr and click on the “Careers” tab.

Start Now and Realize Your Opportunities!

A History of Making Vital Improvements - UMASS Medical School Milestones

1962: Legislation establishes University of Massachusetts Medical School
1970: First medical students begin classes in Shaw Building
1974: First class graduates 16 MDs
1979: PhD program begins
1986: Graduate School of Nursing opens
1986: PhD program becomes Graduate School of Biomedical Sciences
1994: Graduate School of Nursing initiates PhD program
1998: UMass Clinical System and Memorial Health Care merge to form UMass Memorial Health Care
2001: Lazare Research Building opens
2002: Campus Modernization begins on the University Campus
2004: Graduate Entry Pathway Program established at the Graduate School of Nursing
2005: PhD Program in Clinical & Population Health Research established at the Graduate School of Biomedical Sciences
2005: Massachusetts Biologic Laboratories opens new manufacturing and filling facility in Mattapan
2006: Craig Mello, PhD, Blais University Chair in Molecular Medicine and Howard Hughes Medical Institute Investigator, is awarded the Medical School's first Nobel Prize. Dr. Mello shared the 2006 Nobel Prize in Physiology or Medicine with Andrew Fire, PhD, of Stanford University, for their discoveries related to RNA interference.
2007: Michael F. Collins, MD, is named chancellor and Terence R. Flotte, MD, is named dean of the School of Medicine.  
2009: Groundbreaking for the Albert Sherman Center, a 500,000-square-foot research and education facility slated for completion in 2012.
2010: Ambulatory Care Center opens
2012: The Albert Sherman Center, a 500,000-square-foot research and education facility, completed and opens

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