Manager

Description:

The Manager, Integrated Fiscal Strategy will be responsible for designing and executing quantitative analyses to test payment accuracy and appropriateness; evaluating and proposing potential methodological changes to rate development and risk adjustment to better match payment with acuity and advance MassHealth’s strategic goals; communicating quantitative findings and proposed policy changes to external partners, such as health plans and healthcare providers.

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

The Manager will focus on several projects in the near-term for the Integrated Fiscal Strategy team: The role will encompass:

• Rates development for One Care, a program for Medicaid & Medicare dually eligible members that is moving from a pilot program to a more standard managed care model in 2026. The position will focus on near-term and longer term strategy and tasks required to effectively re-think how One Care rates are developed
• Other projects in Integrated Care to improve rate setting and risk adjustment for Integrated Care plans, including SCO and PACE
• Development and execution of a value-based care strategy across different program areas at MassHealth, including development of a value-based care “playbook” as a starting point for MassHealth program teams, and the development of value-based care approaches for specific program areas
• Other operational areas within the Integrated Fiscal Strategy team as needed