GENERAL SUMMARY OF POSITION:

MassHealth Operations (MHO) is currently seeking an experienced supervisor to lead a team of customer service professionals in determining applicant eligibility for health care benefits. As an expert internal resource, you will determine applicant eligibility, interpret policy, mentor, and train staff.

MassHealth, the Commonwealth’s Medicaid program, provides health care benefits to certain low and medium-income Massachusetts residents. As an innovative national leader, the Commonwealth’s Medicaid program offers the opportunity to work with state-of-the-art technologies in a cutting-edge, fast-paced, call center environment. Selected applicants will have exceptional leadership, customer service, communications, and analytical skills. We offer a unique opportunity to serve, and to make a positive contribution to our members.

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

• Supervise a team of customer service professionals who determine applicant eligibility for MassHealth benefits.

• Provide subject matter expertise as an internal resource by assisting subordinate staff in interpreting policy.

• Determines initial and ongoing eligibility for certain MassHealth populations and facilitates the accurate and timely determination of initial eligibility by explaining requirements and following up with applicant(s) who do not submit required verifications.

• Communicates with applicant(s) and/or their authorized representatives to explain programmatic requirements for all Mass Health programs.

• Inputs applicant data into agency’s computer system to establish and update applicant data, validates data, and make corrections on agency computer system.

• Validates applicant demographic, financial and background data by contacting applicant to obtain information not listed on eligibility forms, contacts collateral sources and determines immigrant status by reviewing immigrant documentation.

• Represents agency at hearings by preparing and delivering explanations of eligibility determinations, and explains appeal rights and procedures to applicants, attorneys, advocates, providers, public officials, and the general public.

• Provides requested services and makes appropriate referrals to internal and external programs for which applicants may qualify, and acts as liaison to selected groups.

• Provides quality customer service by responding to all customer inquiries in a professional, efficient and courteous manner.

• Assists the Team Manager in implementing MassHealth Enrollment Center (MEC) and Central Office initiatives; assigning, reviewing and monitoring work; collecting and reporting statistics; staff scheduling; and monitoring time and attendance.

• Assists the Team Manager in developing team members’ skills through training and interpreting agency policies and in developing workflow procedures and communicates with team members to share information to improve performance.

• Assists Team Manager in handling difficult case situations.

• Provides back up to Team Manager and in the Team Manager’s absence, represents the Team Manager where appropriate.

• Completes special projects in accordance with agency directives, including statistical and narrative reports to track and evaluate office performance.

• Performs related work as required including but not limited to: contacting applicants by phone, maintaining and updating policy and procedures manuals, attending staff meetings and training sessions and completing special projects in accordance with agency directives.

Preferred Qualifications:

• Prior supervisory experience in a fast-paced, customer service environment.

• Active, empathetic listener with strong writing and verbal communications skills.

• Genuine service-orientated individual with a commitment to effective customer service and concern for others’ needs.

• Keen attention to detail; the ability to research and analyze complex financial, tax and insurance documents; capacity to assess the value of assets and income.

• Sound judgment with an aptitude to keep composed in difficult situations.

• Proficient usage of Microsoft Office products including Outlook, Word, and Excel.

TO APPLY:

Please upload both Resume and Cover Letter for this position when applying. First consideration will be given to those applicants that apply within the first 14 days.

About MASSHEALTH:

To improve the health outcomes of our diverse members and their families by providing access to integrated health care services that promote sustainable & equitable health, well-being, independence and quality of life.

For more information about our agency and programs please visit: www.mass.gov/masshealth

Pre-Offer Process:

A criminal background check will be completed on the recommended candidate as required by the regulations set forth by the Executive Office of Health and Human Services prior to the candidate being hired. For more information, please visit http://www.mass.gov/hhs/cori

Education, licensure and certifications will be verified in accordance with the Human Resources Division’s Hiring Guidelines.

Education and license/certification information provided by the selected candidate(s) is subject to the Massachusetts Public Records Law and may be published on the Commonwealth’s website.

If you require assistance with the application/interview process and would like to request an ADA accommodation, please click on the link and complete the Reasonable Accommodation Online Request Form

For questions, please the contact the Office of Human Resources at 1-800-510-4122 and select option #2.

First consideration will be given to those applicants that apply within the first 14 days.
MINIMUM ENTRANCE REQUIREMENTS:

REQUIRED WORK EXPERIENCE: At least five years of full-time, or equivalent part-time, professional experience in social work or social casework, claims adjudication, job placement, recruitment, employment counseling, vocational or rehabilitation counseling, credit investigation, educational counseling, legal advocacy, or legal counseling. Based on assignment to second-level supervisory positions, at least one year of this experience must have been in a supervisory capacity.

SUBSTITUTIONS:

• A Bachelor's or higher degree may be substituted for two years of the required non-supervisory experience on the basis of two years of education for one year of experience.

• One year of education equals 30 semester hours. Education toward a degree will be prorated on the basis of the proportion of the requirements actually completed.

No substitutions will be permitted for the required supervisory or managerial experience.
LICENSES: Based on assignment, travel may be required. Those employees who elect to use a motor vehicle for travel must have a current and valid Massachusetts Motor Vehicle Operator's license or the equivalent from another state.

Comprehensive Benefits

When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.

Want the specifics? Explore our Employee Benefits and Rewards!

An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.

The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.