• Government Programs Eligibility & Business Office…

    Cambridge Health Alliance (Cambridge, MA)


    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 the enrollment of PACE participants in government programs including MassHealth and Medicare, as well as in overseeing business office functions, especially related to third-party administrator (TPA) operations.

    Key Responsibilities:

    • Serve as expert in MassHealth enrollment, eligibility requirements, and regulatory compliance standards.

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

    • Oversee Business Office and Third Party Administrator (TPA) operations including claims authorizations, vendor relations, provider contracting, and data operations related to TPA and health plan management.

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

    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._