Provider Network Specialist - Program Coordinator III

The Department of Mental Health (DMH) is seeking a Provider Network Specialist (PNS) to play a critical part in ensuring the effectiveness and compliance of our contracted and state-operated community programs in the Southeast Area. As a PNS, you will leverage your analytical skills to review and analyze data from diverse sources, such as billing and utilization records, quality measures, licensing reports, and service contracts. Your keen insights will be crucial in assessing compliance with program standards and identifying performance trends.

You will also collaborate closely with Site and Area office staff, as well as Central Office teams responsible for licensing, Medication Administration Program (MAP), Utilization management, and contract administration. Your involvement in work groups will contribute to the development, implementation, monitoring, and enhancement of contract and performance management processes. As a key member of the Southeast Area Office team, you will actively participate in internal and external meetings, sharing valuable information, analysis, and recommendations with Area Leadership, DMH Site Offices, and provider representatives.

The PNS position goes beyond traditional contract management responsibilities. You will actively contribute to the improvement of administrative contract management tasks, such as streamlining invoice approval processes and conducting data quality audits. Furthermore, your role extends to developing and delivering training and technical assistance on contract-related processes and priorities, ensuring that knowledge is shared and standards are consistently met across the provider network. If you are passionate about mental health and possess the analytical and collaborative skills necessary for this role, we invite you to join us in making a positive impact on the community's well-being.

Please Note:  This is a full-time position, 40 hours per week on the day shift.  The hours are 8:30 a.m. to 5:00 p.m. Monday through Friday.  Days off are Sunday and Saturday.

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

• Review, summarize and analyze data from multiple sources (e.g., billing and utilization data, quality measures, licensing reports, meeting minutes, service contracts, etc.) to assess compliance with contract and service requirements and performance trends.

• Provide recommendations on areas of improvement for state operated and contracted programs and track progress of performance improvement initiatives, corrective action plans and other follow-up actions.

• Assist with administrative contract management tasks (e.g., invoice approval, record reviews, data quality audits).

• Develop tools to monitor contract/program compliance, performance, and improvement.

• Update, modify, and/or develop correspondence, meeting agendas, minutes, materials, and schedules. Develop and deliver training and technical assistance on contract-related processes and priorities (e.g., data submission, billing, contract expectations, etc.).

• Attend and/or assist in convening internal and external meetings related to provider performance.

• Regularly share information, analysis, and recommendations with Area Leadership, DMH Site Offices, and provider representatives.

• Serve as a resource and content expert for Site and Area personnel related to contract compliance, trends, outcomes, and performance.

• Coordinate within the Area, across Areas, and with Central Office to ensure alignment of service standards and expectations.

Required Qualifications:

• Knowledge of methods for qualitative and quantitative review, summary, and analysis.

• Excellent communication and judgment skills.

• Ability to maintain accurate and concise records.

• Ability to prioritize and multitask duties based on assignment and urgency of tasks.

• Ability to use discretion when handling confidential information.

• Ability to gather information by examining records and documents and by communicating directly with individuals.

• Proficiency with Microsoft Office (including Outlook, Teams, Word, Excel, and PowerPoint) and business intelligence tools such as Tableau or Power BI.

Preferred Qualifications:

• Knowledge of State laws, rules, regulations, policies, procedures, specifications, standards, and guidelines governing agency.

• Knowledge of DMH regulations, contracts, policies, and procedures, and community services.

• Expert proficiency with Microsoft Office (including Outlook, Teams, Word, Excel, and PowerPoint) and business intelligence tools such as Tableau or Power BI.

• Given the population served, bilingual or multilingual fluency.

DMH Vision and Mission:
The Department of Mental Health, as the State Mental Health Authority, assures and provides access to services and supports to meet the mental health needs of individuals of all ages, enabling them to live, work and participate in their communities. The Department establishes standards to ensure effective and culturally competent care to promote recovery. The Department sets policy, promotes self-determination, protects human rights, and supports mental health training and research. This critical mission is accomplished by working in partnership with other state agencies, individuals, families, providers, and communities.

Learn more: https://www.mass.gov/orgs/massachusetts-department-of-mental-health

Pre-Hire 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.

ADA Reasonable Accommodation: If you require a reasonable accommodation with the application/interview process, please contact us at: EOHHS Candidate ADA Requests

For questions regarding this requisition, please contact Executive Office of Health and Human Services, Human Resources at 1-800-510-4122, Option 4.

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

MINIMUM ENTRANCE REQUIREMENTS: Applicants must have at least (A) four years of full-time, or equivalent part-time, professional, administrative or managerial experience in business administration, business management or public administration the major duties of which involved program management, program administration, program coordination, program planning and/or program analysis, and (B) of which at least one year must have been in a supervisory capacity, or (C) any equivalent combination of the required experience and the substitutions below.

Substitutions:

I. A Bachelor's degree with a major in business administration, business management or public administration may be substituted for a maximum of two years of the required (A) experience.*

II. A Graduate degree with a major in business administration, business management or public administration may be substituted for a maximum of three years of the required (A) experience.*

III. A Bachelor's or higher degree with a major other than in business administration, business management or public administration may be substituted for a maximum of one year of the required (A) experience.*

*Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed.

NOTE: No substitutions will be permitted for the required (B) experience.

Salary placement is determined by a combination of factors, including the candidate’s years of directly related experience and education, and alignment with our internal compensation structure as set forth by the Human Resources Division’s Hiring Guidelines. For all bargaining unit positions (non-management), compensation is subject to the salary provisions outlined in the applicable collective bargaining agreement and will apply to placement within the appropriate salary range.

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!

Title 101 CMR 23.00 (“Regulation”) requires certain agency staff to have received the COVID-19 vaccination and Influenza vaccination, or have taken required mitigation measures, to prevent viral infection and transmission in State Hospitals and State Congregate Care Facilities. The Regulation applies to this position. Successful candidates will be required to acknowledge and attest to your vaccination status for both COVID-19 and Influenza.

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.