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Government Programs Eligibility & Business Office Manager - PACE Elder Care Services

**Requisition Number:** 9641

**Location:** CHA East Cambridge Care Center

**Work Days:** 8:00am - 4:30pm, Monday - Friday

**Category:** Professional and Management

**Department:** CHA PACE

**Job Type:** Full time

**Work Shift:** Day

**Hours/Week:** 40.00

**Union Name:** Non Union

About CHA PACE:

**CHA PACE** is a Program of All-Inclusive Care for the Elderly (PACE) at Cambridge Health Alliance. Our mission is to serve adults aged 55 and older with chronic medical and/or mental health difficulties, aiming to achieve the highest level of independence within the community and prevent nursing home placement. We work as a collaborative and high-functioning interdisciplinary team to provide fully integrated medical and behavioral health care, community resources, and in-home support services.

Job Purpose:

The **Government Programs Eligibility & Business Office Manager** plays a critical role in ensuring the accuracy and continuity of PACE participants' enrollment in government programs such as MassHealth and Medicare, while also overseeing the business office functions related to eligibility, enrollment, and financial reconciliation.

Key Responsibilities:

• Serve as CHA PACE’s expert in Medicare and MassHealth enrollment, eligibility requirements, and regulatory compliance standards.

• Collaborate on an interdisciplinary level with our Quality and Compliance, Health Plans Operations, Clinical Operations, and Case Management teams to track and manage MassHealth renewals, long-term care conversions, and Medicare eligibility transitions.

• Ensure timely and accurate communication regarding enrollment issues and resolution efforts with government agencies, participants, family members, care representatives, and internal stakeholders.

• Manage business office functions including enrollment data accuracy, payment account reconciliation, participant self-pay tracking, and long-term care (LTC) patient payment oversight.

• Partner with Health Plans Operations and Finance teams to monitor and resolve issues related to spend-down accounts, vendor invoices, and accounts payable, ensuring financial integrity and compliance.

• Support the involuntary disenrollment process when required, with a focus on transparency, regulatory adherence, and stakeholder coordination.

Qualifications:

• Bachelor's degree in business/healthcare administration or equivalent experience

• Experience in government program operations (Medicare and MassHealth eligibility) highly desired

• Highly organized, excellent written and verbal communication skills, proficient leveraging IT systems to increase overall organizational efficiency and effectiveness

In keeping with federal, state and local laws, Cambridge Health Alliance (CHA) policy forbids employees and associates to discriminate against anyone based on race, religion, color, gender, age, marital status, national origin, sexual orientation, gender identity, veteran status, disability or any other characteristic protected by law. We are committed to establishing and maintaining a workplace free of discrimination. We are fully committed to equal employment opportunity. We will not tolerate unlawful discrimination in the recruitment, hiring, termination, promotion, salary treatment or any other condition of employment or career development. Furthermore, we will not tolerate the use of discriminatory slurs, or other remarks, jokes or conduct, that in the judgment of CHA, encourage or permit an offensive or hostile work environment.

_Cambridge Health Alliance brings Care to the People - including your neighbors, friends and family. Our local hospitals and care centers serve our vibrant, diverse communities, and play an integral role in improving health. As passionate advocates for the underserved, we actively partner with our communities to take on challenging public health issues, and conduct important research to help reduce barriers to care. We believe that everyone deserves access to high quality, convenient health care. This is why our employees believe in where they work and why many build long, rewarding careers at CHA._

_Healthcare is changing rapidly. CHA has a strategic plan that charts a proactive course for our future. It is built on a vision of equity and excellence for everyone, every time. It also recognizes that our workforce is our most valuable asset and prioritizes competitive salaries, benefits and professional development opportunities for employees. The strategic plan is changing the way we provide care and improving the health and experience of our patients; we are looking for smart, committed, compassionate people who want to be part of making our vision of better health and equity a reality._

_At CHA, you can believe in where you work and go home every day knowing you made a difference. Join our team and help us bring Care to the People._