Deputy Director of Health Plan Operations

MassHealth is Massachusetts’s Medicaid and Children’s Health Insurance Program (CHIP). MassHealth provides comprehensive, affordable health care coverage for over two million low-income Massachusetts residents, including 40% of all Massachusetts children and 60% of all residents with disabilities. MassHealth’s mission is to improve the health outcomes of our diverse members and their families by providing access to integrated health care services that sustainably and equitably promote health, well-being, independence, and quality of life.  

The Contract Management and Operations (CM&O) team is part of the Office of Accountable Care and Behavioral Health and is tasked with the oversight and management of MassHealth’s Accountable Care Organizations (ACOs), Managed Care Organization (MCOs), Primary Care Clinician (PCC) Plan, and MassHealth's contracted behavioral health vendor, the Massachusetts Behavioral Health Partnership (MBHP). The ACOs, MCOs, PCC Plan and MBHP are responsible for delivering services to more than 1.5 million MassHealth members and are key partners in improving health care outcomes and driving innovation. 

ACOs are the central managed care delivery system of MassHealth’s current 1115 Demonstration, which has been a critical tool in enabling Massachusetts to achieve and maintain near-universal health coverage, sustain the Commonwealth’s safety net health system, expand critical behavioral health services, and implement reforms in the way that care is delivered. MassHealth ACOs initially launched in 2018 and 17 new ACOs were launched in 2023. ACOs are provider-led managed care organizations accountable for improving quality of care, member experience, and total cost of care. Since 2018, ACOs have transitioned care for over a million members from a largely fee-for-service system towards a value-based payment model where providers are accountable for managing the health of their membership. 

As Deputy Director of Health Plan Administration, the incumbent will manage a team to drive towards improved healthcare outcomes for members, as well as robust and high-quality service delivery and streamlined administrative processes. The Deputy Director will be responsible for managing relationships with key staff across other MassHealth offices (such as Enrollment Operations,  the Office of Long Term Services and Supports (OLTSS), the Pharmacy Office, etc.) and working with them to identify pain points and implement improvements. The incumbent will also be working closely with staff within Accountable Care and Behavioral Health to understand program priorities and present recommendations to unit and MassHealth Leadership. 

The Deputy Director of Health Plan Administration will be expected to oversee multiple efforts in a fast-paced, cross-functional work environment, and coordinate workstreams across multiple teams throughout Accountable Care and Behavioral Health and the agency. They will need to have a working understanding of how technology systems operate in the healthcare space, be passionate about driving change in health care for underserved populations, demonstrate project management expertise, be attentive to detail and have excellent communication skills.

Duties and Responsibilities (these duties are a general summary and not all inclusive):

• Lead administrative management for MassHealth’s Accountable Care Organization (ACO), Managed Care Organization (MCO), and Primary Care Clinician Plan health plans.
• Drive special projects and cross-team process improvement efforts to further enhance the efficiency and continued compliance of the MassHealth managed care health plans.
• Manage relationships with health plans.
• Manage (including developing and recruiting, where applicable), a performance-oriented, high-profile team of capable contract managers an