LTSS Program Specialist, Hybrid

Provider Engagement & PerformanceCommonwealth Care Alliance's Long-Term Services and Supports (LTSS) team is responsible for relationship management with the contracted community-based organizations (CBOs) that provide service coordination and other supports for CCA members. This includes providing ongoing training and technical assistance on policies and procedures, interfacing with other CCA departments to promote strong working relationships between CCA staff and CBOs and the ongoing evaluation of the appropriateness, efficiency and quality of the services provided. The LTSS Program Specialist will have a wide range of responsibilities including project management support, data review, documentation, and assisting external partners. There will be opportunities to contribute beyond the essential duties and responsibilities listed below based on individual interest and demonstrated capabilities. The position will report to the LTSS Program Manager.Reporting to the Manager, LTSS Program, this position supports the efficient operations and performance of CCA's contracted CBOs by providing project management support and performing specified administrative functions, including, but not limited to: (a) invoice management, (b) member roster management, (c) coordination of onboarding and training of related CBO staff, (d) data review, reporting and analysis, and (e) assistance to these external partners as necessary. The Specialist is expected to work with managers and staff across the organization as well as interface with external community-based partners. There will be opportunities to contribute beyond the essential duties and responsibilities listed below based on individual interest and demonstrated capabilities.Supervision Exercised: No, this position does not have direct reports.Essential Duties & Responsibilities:Support LTSS network program operationsDeveloping agendas, taking, and disseminating notes, documenting action steps, communication, and follow-up with members of group with the oversight of the Manager, LTSS ProgramSchedule regular check in meetings/calls with ASAPs and LTSC AgenciesPerformance reporting/data management supportLink with CCA's Business Intelligence team and Provider Engagement Analytics Manager to request reports as neededPerform data quality checks, and additional data review stepsContribute to the development of reports to share with CBOs to provide information about their operations and performanceContinued development of specifications for reports; work with finance, business intelligence and other CCA teams to develop, implement and update existing reportsSupport maintenance of reporting inventoryRoster Reporting and ReconciliationPartner with CCA's Eligibility Team to obtain and perform data entry on information from ASAPs and LTSC Agencies related to member rosters and enrollment recordsPerform data quality checks, and additional data review steps, to ensure data integrity of member record to include accurate ASAP, LTSC Agency, GSSC and LTSC, among other detailsCoordinate Provider Rosters with the Provider Data Networks TeamDisseminate information to CBOsSupport Manager in developing guidelines, reference guides, workflows and SOPs, disseminating them to CBOs and answering questions to ensure efficient day to day operationsDraft email communications under supervision of ManagerMaintain materials and design of CCA Extranet/Sharepoint as a key resource for informationOngoing communication with CBO staff and CCA internal departments through email and phone callsOnboardingManage onboarding process to ensure all trainings and documentation are completedConnect with appropriate departments across CCA to complete Onboarding processManage role transitions and terminations by checking in with appropriate departments across CCA and confirming termination of access to CCA accounts (Reporting, ECW, Extranet, Guiding Care, LMS, and others)Update Staffing lists on a monthly basis and share with appropriate teams across CCAManage Assignment Transfer process and workflow for CBOs related to agency or GSSC and LTSC assignment transfersSupport ad hoc trainings and meetingsPrepare meeting materials, agenda creation, note-taking, and manage other meeting logistics for meeting bringing together all CBOs with key CCA staff to share best practices and lessons learnedCoordinate with CBOs to ensure staff registration and participationMaintain training agendas, presentations, and attendance sheetsSupport LTSS Program Manager in times of auditsContribute to maintaining relationships with internal departments and partnered organizations as needed to promote the goals of LTSS ProgramTrack support tickets to ensure resolutionManage tracking logs for assignment transfers, support tickets, issue escalations, extranet, and communicationsOther duties as assignedWorking Conditions:This is a remote or hybrid role with the expectation of working according to Commonwealth Care Alliance's standard operating hours of 8:30am-5pm Monday-Friday.Required Education (must have):Bachelor's degreeDesired Education (nice to have):Bachelor's degree in public health, health management, social work, or a related field preferred.Required Experience (must have):1+ years of experienceDesired Experience (nice to have):Experience with dual-eligible (DSNP) populations preferred. 1+ years of experience in LTSS, social work, provider relations, healthcare communications, project management, or network management within a health plan or similar environment.Required Knowledge, Skills & Abilities (must have):Ability to learn new systems and databases that CCA implementsWorking knowledge of Medicare and Medicaid (MassHealth)Familiarity with and full support of independent living, recovery, and person-centered planning philosophy and strategiesMust be proficient in the use of computers, specifically Microsoft Office suiteDemonstrated skills in Excel and PowerPointExperience or knowledge of community based services for seniors and disabled individuals, including extensive knowledge of the ASAPsPolished, professional presentation skills in working with key provider partners and internal leadersExceptional written and verbal communication skills, with the ability to translate complex information for diverse provider and internal audiencesExcellent organizational, analytical, and problem-solving abilitiesAbility to build and maintain positive relationships and collaborate effectively with internal and external stakeholdersProactive in identifying issues and developing effective solutionsAdaptable and able to thrive in high-pressure environments, adjust to shifting priorities, and manage multiple deadlinesResults-oriented and self-motivated, with the ability to work independently and as part of a team to meet departmental goalsDemonstrates empathy, self-awareness, and the ability to navigate sensitive conversations diplomaticallyMust be able to work collaboratively and create an atmosphere of trust and respect within project teams and with external partnersMust be highly organized and self-directed with a proven ability to work with supervision on departmental and cross-functional projects of a diverse natureRequires excellent interpersonal skills in order to communicate and work with staff and external partners of all skill and experience levelsStrong tactical performerDemonstrated ability to establish and manage performance and outcome metricsAbility to establish and maintain positive and effective work relationships with internal staff, external vendors, and state and federal agenciesProven skills, knowledge base and judgment necessary for independent decision-makingExcellent organizational, time-management and problem-solving skillsMust be able to exercise a high level of diplomacy to recognize politically sensitive issuesAbility to multi-task and switch gears quickly / effectivelyRequired Language (must have):EnglishDesired Knowledge, Skills, Abilities & Language (nice to have):Familiarity with provider network management systems and healthcare data standardsProject management skills with the demonstrated ability to handle multiple projectsStrong understanding of Medicare, Medicaid, duals program, and health plan operations, including regulatory and compliance requirementsDemonstrated knowledge of DMH system and waiver programs helpfulDemonstrated ability to describe and assess a simple business problem