The Senior Manager of Program Integrity reports to the Senior Director of Data, Performance, and Reporting and leads strategic efforts to identify, assess, and mitigate fraud, waste, abuse, and other program integrity risks across ACBH programs. This role serves as the primary liaison between MassHealth's centralized Program Integrity team and ACBH program teams, ensuring alignment on priorities and coordinated implementation of program integrity initiatives.

The Senior Manager will work across policy, operations, analytics, and program teams to strengthen oversight processes, implement policy and regulatory changes, manage complex cross-functional initiatives, and provide strategic recommendations to executive leadership. This role is well suited for candidates who enjoy solving complex problems, influencing across teams, and driving meaningful improvements in large-scale healthcare programs.

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

• Serve as the primary liaison between the centralized Program Integrity (PI) team and ACBH program teams; align priorities, facilitate communication, coordinate initiatives, validate PI team findings, and translate between program realities and program integrity objectives to identify balanced, practical solutions.
• Build, implement, and manage structured processes to identify, prioritize, and track program integrity risks and mitigation strategies across program teams, PI, and executive leadership, including establishing workflows, governance structures, and accountability mechanisms.
• Develop, refine, and implement policy and regulatory changes in partnership with program and policy teams, and draft and coordinate related communications to providers and external stakeholders.
• Project manage program integrity initiatives across ACBH, coordinating across program and PI teams to ensure progress, accountability, and timely delivery of key milestones and deliverables.
• Identify data needs and review and synthesize analyses to identify trends, risks, and opportunities for action in collaboration with program, program integrity, and analytics teams.
• Support executive leadership by developing executive-level readouts, synthesizing insights, and providing strategic recommendations to inform decision-making processes.
• Respond to urgent agency, legislative, or regulatory priorities as needed, including rapid analysis, coordination, and communication.

Preferred Qualifications:

• 3-5 years of experience in an analytical, policy analysis, or strategy role.
• Advanced Excel and PowerPoint skills.
• Strong analytical, problem-solving, and communication skills.
• Ability to manage multiple priorities and perform under tight deadlines.
• Experience leading projects and coordinating cross-functional work.
• Strong interpersonal skills and ability to build working relationships.
• Self-starter with an entrepreneurial mindset and ability to work independently.
• Experience in healthcare or related fields.
• Passion for public service.

TO APPLY:

Please upload both Resume and Cover Letter for this position when applying. First consideration will be given to those applicants that apply within the first 14 days.

Qualifications:
MINIMUM ENTRANCE REQUIREMENTS:

Applicants must have at least (A) five (5) years of full-time or, equivalent part-time, professional, professional internship, administrative, supervisory, or managerial experience in business administration, business management, public administration, public management, clinical administration or clinical management or (B) any equivalent combination of the required experience and substitutions below.

Substitutions:

I. A certificate in a relevant or related field may be substituted for one (1) year of the required experience.

II. A Bachelor's degree in a related field may be substituted for two (2) years of the required experience.

III. A Graduate degree in a related field may be substituted for three (3) years of the required experience.

IV. A Doctorate degree in a related field may be substituted for four (4) years of the required 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.

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