Careers

About the Massachusetts Health Connector

The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth.  The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers.  The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.

The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its work force.  We consider qualified applicants without regard to race, color, religion, gender, sexual identity, gender identity, national origin, or disability.

Appeals Research Associate

The Appeals Research Associate is responsible for facilitating the resolution of administrative eligibility appeals and appeals of the Massachusetts Healthcare Tax Penalty. The role includes responsibility for carrying out the informal dispute resolution process mandated by the Affordable Care Act.   The candidate needs to possess well developed outreach and organizational skills and the ability to accurately complete special assignments in a timely manner.

The Appeals Research Associate will be responsible for:

  • Examining received appellant appeals documentation
  • Researching needed information in multiple systems to retrieve and validate data
  • Reviewing and resolving appeal issues in compliance with timeframe mandated by regulations
  • Communicating by telephone and in writing with appellants, their representatives, hearing officers, Connector Operations, Mass Health, the Department of Revenue and individuals to informally resolve appeals
  • Scheduling hearings with hearing officers and issuing hearing notices to appellants
  • Preparing documentation and supporting hearing officers on the day of hearings
  • Proofreading hearing officer decisions prior to issuing determinations to appellants
  • Providing case management to ensure appeal status is documented and case files are complete and up to date
  • Identifying recurring appeal issues to flag for review by Connector Operations
  • Assisting co-workers with administrative tasks as needed

Qualifications:

  • BA preferred.
  • Bilingual Spanish/English abilities are beneficial but not required.
  • Experience in healthcare, commercial insurance, administrative law, databases, conflict resolution, customer service or call center, Medicaid or advocacy work are helpful.
  • Ability to effectively manage workload and adjust to changing priorities.
  • Excellent customer service skills including the ability to ask appropriate questions and actively listen to identify underlying questions and issues (root cause analysis).
  • Solid research skills and experience maneuvering through multiple systems to access files to retrieve and validate data.
  • Proficiency in Microsoft Office.
  • A strong commitment to teamwork and a team environment.

Work Setting:

  • This position requires the employee to work on-site in a closed office setting
  • Due to COVID-19, we are currently working from home.
  • Employee may be requested to work an extended day and weekends to meet deadlines

Salary: Salary range is competitive; salary will be commensurate with experience.

If Interested: Send cover letter and resume to Connector-jobs@state.ma.us. 

Please note: Due to the requirement of 268A, please complete the disclosure form and return with your application.

About the Health Connector:

The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth. The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers. The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.

The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its workforce. We consider qualified applicants without regard to race, color, religion, gender, sexual identity, national origin, or disability.

Small Group Account Coordinator

Position Summary:

The Small Group Account Coordinator provides day-to-day operational and account management support to brokers and small employer groups regarding the Health Connector for Business platform and associated products.  The Small Group Account Coordinator will educate and train stakeholders about the online shopping tools, health plans, and programs offered through the Health Connector for Business. The Small Group Account Coordinator is also responsible for providing guidance to streamline and improve the small business platform. The position reports to the Associate Director of Health Connector for Business.

Key Responsibilities include:

  • Act as the day-to-day service liaison for direct small employer groups, brokers, and other distribution channels.
  • Provide accurate and timely responses, assistance and guidance on all Health Connector for Business product, plan, and policy-related needs
  • Provide telephonic outreach to brokers and direct employer groups regarding the Health Connector for Business online system and all associated products, including demonstrations of the platform
  • Track and follow-up with potential sales leads generated from collective outreach efforts; including oversight and analysis of broker and client databases
  • Oversee research and resolution of broker and employer issues, including: gathering required information, coordinating vendor resources, ensuring the timely and accurate analysis of issues, identifying steps for issue resolution, and completing the appropriate communications
  • Provide quotes to brokers and employer groups as necessary
  • Maintain positive and productive working relationships between the Health Connector, carriers, vendors, brokers, employers, and other distribution channel partner
  • Assist in the improvement of the small business service model
  • Act as the primary subject matter expert for small business system improvements and changes including prioritization of enhancements
  • Work with internal stakeholders to ensure proper data is reporting to determine progress and growth of the small business platform

Experience and Qualifications:

  • Bachelor’s Degree is required
  • Strong MS Office Suite skills (including Excel and PowerPoint) are required
  • Proven analytical and research skills
  • Must have excellent communication skills, both written and verbal, as well as outstanding interpersonal skills and the ability to work with multiple parties and vendors to implement projects
  • Ability to work in a complex, fast-moving, and cross-functional environment
  • Ability to maintain confidentiality consistent with the values and integrity of the Connector
  • Understanding of and experience working with employers in the small group segment helpful
  • Basic knowledge of Massachusetts health and dental market and those carriers’ health insurance products preferred

Salary: Salary range is competitive; salary will be commensurate with experience.

Work Setting: This position requires the employee to work on-site.

If Interested: Send cover letter and resume to Connector-jobs@state.ma.us. 

Please note: Due to the requirement of 268A, please complete the disclosure form and return with your application.

About the Health Connector:

The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth. The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers. The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.

The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its workforce. We consider qualified applicants without regard to race, color, religion, gender, sexual identity, national origin, or disability.

Eligibility and Enrollment Operations Analyst

Position Summary:

Reporting to the Enrollment Manager, the Eligibility and Enrollment Operations Analyst will serve as a Subject Matter Expert (SME) in Eligibility and Enrollment rules implementation, business validation and production oversight, working with internal teams and external partners and stakeholders to communicate impacts and determine next steps to resolve defects and implement changes as needed.  This position requires the ability to work collaboratively and cross-functionally with IT partners and vendors to drive business objectives and fulfill responsibilities.

Responsible to:

  • Understand CCA eligibility policies and how these should be executed in operations and reflected in system functions to achieve intended results.
  • Document, manage, and monitor changes in functionality needed based on program changes driven by policy and/or changes to laws and regulations.
  • Monitor production process outputs and raise production support issues using established issue tracking systems and software.
  • Communicate urgent issues or significant impacts to internal stakeholders.
  • Coordinate with vendors’ operations, testing and production support teams to suggest fixes to complex issues by doing a thorough analysis of root cause and impact of the defect which may include soliciting feedback from internal stakeholders and leading cross-functional working sessions to ensure understanding of the issue and resolution.
  • Ensure proper prioritization of defects and escalated tickets for Health Connector’s critical business functions.
  • Participate in Joint Application Design (JAD) sessions as an Eligibility and Enrollment SME.
  • Create business validations plans, document test cases, expected and actual results, and coordinate planning and execution of business validations with internal teams, IT partners and vendors.
  • Participate in day to day operational activities including attending ongoing operations and status meetings, participating in working sessions, release planning meetings, defect prioritization meetings, issue trouble shooting sessions and service recovery activities.
  • Provide program support as an Eligibility and Enrollment SME in areas such as member/stakeholder communications, business process design, business operations, policies & procedures.
  • Ensure end-to end business processes are documented and updated on a regular basis to reflect current state.
  • Create, distribute and manage meeting materials and project artifacts such as project plans, power point presentations, operating procedure documentation, risk and decision registers etc.
  • Work collaboratively with the Health Connector internal teams (business, policy, legal and IT) and vendors to coordinate eligibility and enrollment activities, business validations, and other operational and project activities.
  • Interact with key stakeholders including advocates, other state agencies, health plans and vendors to exchange information and/or address specific issues related to the associate’s responsibilities.
  • Monitor relevant reports to track process performance and quality.
  • Perform other responsibilities and participate in projects based on ongoing business needs and as assigned by management.

Experience and Qualifications:

  • A Bachelor’s degree is required
  • Experience in health care, insurance, and/or government operations preferred
  • Vendor Management experience strongly preferred
  • Understanding of Health Insurance industry, the ACA and eligibility rules
  • Understanding of SDLC and testing methodologies
  • Proven analytical and problem-solving skills
  • MS Excel and PowerPoint skills and experience analyzing large datasets using MS Excel
  • Strong organizational, oral and written communication skills
  • Comfort in a fast-paced environment with competing priorities
  • Demonstrated ability to work collaboratively and effectively in a cross-functional environment
  • Self-starter who can work independently

Salary: Salary range is competitive; salary will be commensurate with experience.

Work Setting: This position requires the employee to work on-site in an open office setting.

Please note: Currently all staff are working from home due to COVID-19 precautions, but will return to the office setting when safe.

If Interested: Send cover letter and resume to Connector-jobs@state.ma.us. 

Please note: Due to the requirement of 268A, please complete the disclosure form and return with your application.

About the Health Connector:

The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth. The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers. The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.

The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its workforce. We consider qualified applicants without regard to race, color, religion, gender, sexual identity, national origin or disability.

Contact Center Performance Coordinator

The Contact Center Performance Coordinator, under the direction of the Contact Center Performance Manager, provides day-to-day monitoring of key contact center performance metrics. Contact Center consists of call center, back office and Customer Interaction Centers (CIC). Metrics are used to inform training needs, trends, and ensure agents are providing best possible service to Health Connector members. This position requires close and collaborative work with the vendor responsible for contact center delivery. This is a key role in the delivery of exceptional service to Health Connector members.

Responsibilities include:

  • Monitoring all contact center performance metrics and staffing levels.
  • Provide support and coordination on various projects and activities related to contact center performance, including Open Enrollment ramp-up and performance improvement efforts.
  • Under the direction of the manager, develop and prepare data analysis of contact center performance to be used in various forums to inform Senior Leadership of vendor’s performance.
  • Monitor contact center service level agreements (SLAs)/key performance indications (KPIs) and recommend appropriate incentives or penalties per contractual agreements with vendor.
  • In concert with the contact center team, monitor Customer Satisfaction results, collaborate with vendors on action plan to address negative responses and identify alternative methods to collect and respond to member feedback
  • Support development and/or review of training and communication materials for the contact center.
  • Research and report unique and urgent member issues in a timely and professional manner to contact center vendor.
  • Participate in Quality Assurance Activities such as call monitoring, case reviews, and call calibration sessions to assess whether or not the contact center vendor is meeting the needs of the Health Connector and its customers
  • Assist with other contact center and service recovery activities as needed and assigned.

Qualifications:

  • The ideal candidate will have a working knowledge of state and national healthcare reform and health insurance.
  • BA or BS required.
  • Master’s Degree and familiarity with the healthcare industry, public or private, is preferred.

Other desired skills include:

  • Excellent analytical skills, excellent communication skills, both written and verbal, as well as outstanding interpersonal skills and the ability to work with multiple parties and vendors to implement projects
  • Ability to work independently and on a team
  • Commitment to the goals of the Connector and Health Care Reform; ability to support a wide range of constituents in a constructive and informed manner

Salary: Salary range is competitive; salary will be commensurate with experience.

Work Setting: This position requires the employee to work on-site in an open office setting.

Please note: Currently all staff are working from home due to COVID-19 precautions, but will return to the office setting when safe.

If Interested: Send cover letter and resume to Connector-jobs@state.ma.us. 

Please note: Due to the requirement of 268A, please complete the disclosure form and return with your application.

About the Health Connector:

The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth. The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers. The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.

The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its workforce. We consider qualified applicants without regard to race, color, religion, gender, sexual identity, national origin or disability.

Health Plans and Operations Manager

The Health Plans and Operations Manager serves as the main day-to-day operational liaison between carrier partners and the Health Connector. The manager maintains and enhances the Health Connector interactions with carrier and vendor partners as related to operational processes. The position reports to the Associate Director of Health and Dental Plan Operations.

Key Responsibilities include:

  • Act as a liaison with health and dental carriers, maintaining positive and productive working relationships between the Health Connector and contracted health and dental plans. Represent carriers’ operational interests in internal activities, meetings, and communications. Oversee research and resolution of health and dental plan issues, including gathering required data, coordinating vendor and internal Connector resources, ensuring the timely and accurate analysis of issues, identifying steps for issue resolution, and complete the appropriate communications to carriers and internal partners
  • Work with carrier partners, vendor partners, and internal stakeholders to assess and implement system changes that impact carriers, ensuring carriers are made aware of system changes timely and provided accurate and detailed information on projects or system changes
  • Coordinate external service meetings between Health Connector and health and dental carriers, external business vendors, and lead internal cross departmental meetings including setting agendas, chairing those meetings and ensuring that all active issues are addressed expeditiously
  • Support finance team and vendors in health and dental plan reconciliations to ensure timely, accurate and complete determinations. Monitor and establish metrics to evaluate vendor performance with input from internal and external stakeholders. Work with internal stakeholders to ensure proper data is reporting as requested from carriers or other stakeholders.
  • Support the day to day operations for Qualified Dental Plan operations including, but not limited to:
    • Review escalated cases and manage communication as required by coordinating carrier(s), vendor(s) and internal Connector resources, to ensure cases are resolved expediently within established guidelines
    • Serve as a subject matter expert for dental operations and work with the Associate Director of Health and Dental Plan Operations to monitor agreed upon dental metrics to ensure operational standards and turnaround times are consistently met; and represent dental operations for any modification and improvement initiatives
    • Coordinate annual dental renewal processes, monitoring agreed upon dental metrics to ensure operational standards and turnaround times are consistently met

Additional Responsibilities:

  • Work with the Associate Director of Health and Dental Plan Operations to modify and improve health and/or dental plan facing policies and/or procedures
  • Monitor health and dental plan compliance with Health Connector policies and procedures, identify areas requiring improvement and lead efforts to ensure compliance
  • Prepare and deliver presentations and memoranda to internal and external parties
  • Participate in cross-functional internal collaborations and projects
  • Other projects and duties as assigned by Associate Director of Health and Dental Plan Operations

Experience and Qualifications:

  • Bachelor’s Degree is required
  • Experience with Massachusetts Health and Dental carriers and knowledge of those carriers’ health insurance products
  • Health care experience and background including knowledge of both the public and private sectors
  • Strong operations and project management background, with the ability to work on complex projects and meet deliverables within tight timeframes
  • Excellent communication skills, both written and verbal, as well as outstanding interpersonal skills and the ability to work with multiple parties and vendors to implement projects.

Preferred requirements:

  • Master’s Degree in Health care, business, public health or policy strongly preferred
  • Prior experience working at a health or dental plan
  • Bilingual skills

The ideal candidate must be able to work successfully in a fast-paced environment, have proven ability to successfully multi-task, possess outstanding verbal and written communication skills, strong organizational, project management, analytical, and leadership skills, be able to successfully work independently or on a team, consistently exercise sound judgement, and demonstrate the ability to discern when an issue or situation should be escalated to management.

Salary: Salary range is competitive; salary will be commensurate with experience.

Work Setting: This position requires the employee to work on-site in an open office setting.

Please note: Currently all staff are working from home due to COVID-19 precaution but will return to the office setting when safe.

If Interested: Send cover letter and resume to Connector-jobs@state.ma.us. 

Please note: Due to the requirement of 268A, please complete the disclosure form and return with your application.

About the Health Connector:

The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth. The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers. The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.

The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its workforce. We consider qualified applicants without regard to race, color, religion, gender, sexual identity, national origin or disability.

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