MassHealth Program Manager

massgeneralbrigham; United States; On-site; USD 95,000 - 130,000; Full time

Job summary

Mass General Brigham Health Plan is seeking a project/program manager to support the MassHealth line of business, focusing on governance, regulatory reporting, and operational processes. You will work with cross-functional teams to ensure timely delivery and compliance with contractual requirements.

The role emphasizes collaboration with leadership and stakeholders, and involves coordinating reporting calendars, documentation, and process improvements within a fast-paced healthcare environment.

Qualifications

• 3–5 years of project or program management experience.
• 1–2 years of Medicaid, MassHealth, or government program experience preferred.
• Experience managing regulatory reporting and compliance workflows.
• Strong coordination and communication across multiple stakeholders.
• Knowledge of MassHealth contractual requirements is a plus.

Responsibilities

• Coordinate MassHealth operational activities and initiatives by maintaining timelines and tracking deliverables.
• Prepare, compile, and submit routine MassHealth regulatory reports and contractual deliverables.
• Maintain documentation, governance materials, and action logs to support compliance.
• Assist leadership in coordinating stakeholder communications and ensuring timely follow-up.
• Support massHealth-related initiatives and system updates across departments.

Skills

Project management

Regulatory reporting

Stakeholder coordination

MassHealth knowledge

Education

Bachelor's degree

Tools

OnBase

POSC

Virtual Gateway

SharePoint

Teams

Job description

Site: Mass General Brigham Health Plan Holding Company, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.

We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.

Responsible for supporting the appeals and claims resolution process, ensuring timely submission and follow-up on appeals. Assists with gathering documentation, tracking case statuses, and coordinating communications between departments to ensure the accurate handling of claims

This role supports the day-to-day administration and operations of the MassHealth line of business. Working under the guidance of leadership, this role coordinates regulatory reporting, operational processes, stakeholder communications, and governance activities to support compliance with contractual requirements and organizational objectives. The position maintains documentation, tracks deliverables and action items, facilitates communication among stakeholders, and assists with the execution of MassHealth-related initiatives. The role follows established policies, procedures, and priorities while escalating complex issues and recommendations to leadership.

Essential Functions

• Coordinate assigned MassHealth operational activities and initiatives by maintaining timelines, tracking deliverables, documenting progress, and following up with stakeholders to support the timely completion of work.
• Prepare, compile, and submit routine MassHealth regulatory reports and contractual deliverables, including quarterly, semi-annual, annual, and ad hoc submissions, in accordance with established requirements and timelines.
• Receive, track, and distribute MassHealth communications to appropriate stakeholders; monitor responses and follow-up activities; and escape issues requiring management review or decision-making.
• Coordinate governance, committee, and meeting activities by scheduling meetings, preparing materials, documenting meeting outcomes, maintaining action-item logs, and supporting follow-up activities.
• Support MassHealth operational processes, including benefit and reimbursement updates, bulletin and transmittal tracking, redetermination activities, member assignment processes, provider enrollment coordination, PIDSL maintenance, practice closure activities, discharge tracking, and related system updates.
• Maintain reporting calendars, submission schedules, templates, process documentation, and departmental records to support compliance with -MassHealth contractual requirements.
• Assist internal stakeholders in collecting information, monitoring operational activities, and coordinating follow-up actions related to quality, health equity, care management, member experience, provider operations, finance, community partner performance, and MGB ACO initiatives.
• Maintain shared resources, systems access, and departmental tools, including OnBase, POSC, Virtual Gateway, SharePoint, Teams sites, reporting libraries, and reference materials.
• Produce routine reports, maintain operational data and documentation, and support leadership in monitoring departmental performance and compliance activities.
• Identify operational issues, process gaps, or delays and communicate findings to leadership for review and guidance.
• Performs other duties as assigned
• Complies with all policies and standards

Qualifications

Education

Bachelor's Degree required; experience can be considered in lieu of a degree

Experience

At least 3-5 years of experience in project or program management required

At least 1-2 years of experience with Medicaid, MassHealth, or government programs preferred

At least 1-2 years of experience managing reporting processes and compliance workflows preferred

Knowledge, Skills, and Abiliti