Medicare Savings Program Manager (MSP)

Overview

Working as a member of the Medicare Eligibility Enhancement Programs Team at Health Care Finance Solutions (HCFS), the Medicare Savings Program Revenue Manager is responsible and accountable for oversight of all day-to-day operations of the Medicare Savings Program Unit. The Medicare Savings Program is responsible for administering the Massachusetts Medicare Savings Program on behalf of MassHealth and the Massachusetts Executive Office of Health and Human Services. Under the direction of the Director or designee, the primary responsibilities of the Revenue Manager include the implementation and management of Medicare Savings Program policies and procedures, program reporting, enhancement of current program initiatives and supervision of program staff. The Revenue Manager will act as a liaison with various entities, including state and federal agencies, community resources and program recipients, to exchange information, coordinate activities, provide training, and resolve issues. The Revenue Manager will oversee and provide direct customer service to MassHealth members, their families and providers to provide information and investigate and resolve issues related to Medicare coverage, eligibility, and premium payments. The Medicare Premium Assistance Revenue Manager’s primary goal is to ensure the accuracy and integrity of Medicare coverage information and premium payment transactions within MassHealth systems and manage Medicare Premium Assistance Programs participation to assure coordination of Medicare benefits with MassHealth and support MassHealth as the Payor of Last Resort.

Responsibilities

• Evaluate and assist in implementing change to increase the efficiency of operations by reviewing reports and information from staffing.
• Support and oversee revenue program by monitoring the progress of revenues and analyzing the data and reports.
• Perform supervisory functions of hiring, corrective action and employee performance evaluation.
• Make recommendations for priorities and program implementations.
• Make recommendations for improvements to program operations.
• Closely monitor the revenue activities in the assigned unit to ensure the regular status of the revenues and report on the potential risks for shortfalls or potential gains.
• Assist in developing and implementing policy and procedure standards in regards to program monitoring and evaluation.
• Oversee and monitor activities of assigned unit.
• Work on revenue management projects.
• Identify state programs that may be eligible to receive FFP from the Federal Government.
• 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.
• Respond to inquiries from EOHHS staff and others concerning assigned projects.
• Perform related duties such as attending staff meetings, maintaining records and preparing reports.
• Interact and represent the department on a professional level with EOHHS and other government agencies.
• Work individually as well as being a team member.
• Work internally and externally to resolve discrepancies for projects.
• Perform other duties as assigned.

Qualifications

Additional Information

About Health Care Finance Solutions at ForHealth Consulting and Medicare Eligibility Enhancement Programs Team : Health Care Finance Solutions (HCFS) is a part of ForHealth Consulting, the health care consulting division of UMass Chan Medical School, Massachusetts’ only public medical school. As nationwide leaders in the development and implementation of health care reform, ForHealth Consulting and HCFS stay ahead of health care trends and help strategize and plan for changes that impact both health care delivery systems and patients on the local, state and national level. Located in Shrewsbury, MA, HCFS helps state agencies identify opportunities to increase savings and reimbursements through federal and other third-party sources, establish effective savings and reimbursement programs and capitalize on all possible revenue streams. At the same time, we identify opportunities for our clients to increase health care-related services, reduce the net cost of delivery and help ensure individuals receive the health and human service benefits to which they may be entitled. The Medicare Eligibility Enhancement Programs (MEEP) Team at HCFS works with state Medicaid programs to identify and coordinate federal and state benefits for program recipients, helping ensure that individuals receive all benefits to which they are entitled. The MEEP team develops and implements benefit coordination initiatives which achieve cost savings and revenue opportunities for Medicaid agencies by ensuring federal benefits are appropriately identified and coordinated for state program recipients. The team focuses on identifying and coordinating eligibility for Social Security, Medicare and Medicare Savings Program benefits for state Medicaid recipients. Current activities include identification of Medicare benefits, assistance with the Medicare application and enrollment process, review of eligibility for Social Security benefits and reconciliation of state Medicare premium payments.

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