Lead Healthcare Policy Analyst

Company: Commonwealth of Massachusetts
Location: Boston
Posted on: May 28, 2025

Job Description:

An Official website of the Commonwealth of MassachusettsJob Description - Lead Healthcare Policy Analyst (250004RP)Job DescriptionDescriptionAbout the Office of the Inspector General (OIG or Office)Since its creation as the nation's first state-level inspector general's office, the Massachusetts OIG has been at the forefront of promoting effective government and the responsible use of public money and property. The OIG is an independent agency charged with preventing and detecting fraud, waste and abuse in the use of public funds and public property. By statute, the Inspector General (IG) has broad authority to oversee the use of state, local and federal funds by state and local governments, as well as by those who receive government funds or use of public property. This includes state agencies, counties, cities, towns, quasi-governmental authorities and districts, as well as individuals, corporations and not-for-profit organizations that do business with the government.The Office is led by the Inspector General of the Commonwealth, who is appointed by the Governor, Attorney General and Auditor "...solely on the basis of integrity and demonstrated ability in accounting, auditing, financial analysis, law, management analysis, public administration, investigation or criminal justice administration." M.G.L. c. 12A, - 2.The OIG is organized into three bureaus: Specialty & General Government, Legal & Compliance, and Operations, Training & Publications. Each bureau contains divisions that focus on specific agencies, issues or functions. Together the bureaus work to prevent and detect waste, fraud and abuse of public resources in the Commonwealth. Additional information about the office may be found at Welcome to the Office of the Inspector General - Mass.gov.The Specialty and General Government Bureau is managed by the Deputy Inspector General. This bureau safeguards public assets through oversight of specific agencies (both statutory and OIG-created divisions), special government funding (like pandemic relief), public procurement, and state and local government.Health Care DivisionIn 2023, Inspector General Jeffrey Shapiro shifted the review of Medicaid (MassHealth) and the Health Safety Net (HSN) programs to the newly created Healthcare Division (HCD) to review, analyze, and report on a variety of healthcare policy, delivery, and access issues in addition to conducting the OIG's annual study of MassHealth and HSN, as required by Section 231 of Chapter 140 of the Acts of 2024. The OIG's HCD conducts oversight reviews, audits, and investigations of the MassHealth and HSN programs to prevent and detect fraud, waste and abuse in publicly funded healthcare programs. HCD, through its oversight activities, makes recommendations for improvements to program internal controls to safeguard public funds in the MassHealth and HSN programs.Located within the Executive Office of Health and Human Services, the MassHealth program provides health insurance benefits to more than 2 million Massachusetts residents. In FY 2025, the Commonwealth expects to spend approximately $20.3 billion on MassHealth Administered by the Office of Medicaid, HSN provides access to essential health care services for low-income, uninsured or underinsured Massachusetts residents by paying acute care hospitals and community health centers for medically necessary services provided to qualifying residents with an annual budget of approximately $347M.The Office of the Inspector General serves the interest of the public by preventing and detecting fraud, waste and abuse of public funds and property and promoting meaningful transparent and efficient oversight of government programs. In its oversight and fraud prevention and detection role, members of HCD identify areas of risk and develop program reviews to identify fraud, waste and abuse. As a result of the reviews and investigations, HCD drafts and publishes reports and recommendations for improved program integrity processes to safeguard important tax dollars in publicly funded healthcare programs.When you join the OIG's HCD, you will be engaging in critical work to fulfill the mission of safeguarding public funds and ensuring accountability, transparency and integrity in publicly funded healthcare programs. You will review healthcare data and evaluate claims and payment data to identify program performance issues, recommend strategies to reduce fraud, waste, and abuse, and strengthen oversight of MassHealth and HSN programs. Your insights will play a key role in enhancing accountability and efficiency within public healthcare programs.The OIG seeks a Lead Healthcare Policy Analyst to join the HCD to support MassHealth and HSN oversight through investigations and reviews that result in reported findings and recommendations. The right candidate for the Lead Healthcare Policy Analyst has an innate sense of curiosity combined with prior healthcare policy evaluation experience and understands the complexity of MassHealth programs and the member population it serves. The candidate may also have experience working in and or with government agencies focused on public healthcare policy, evaluation and analysis.Bring your talent and experience and join a dynamic, collaborative team dedicated to improving government efficiency and safeguarding public healthcare. As a creative problem solver, you leverage diverse data sources to evaluate MassHealth and HSN programs, providers, and vendors, identifying inefficiencies, fraud, waste, and abuse. Your extensive understanding of public health policy and strong organizational and communication skills enable you to develop and manage short- and long-term projects in collaboration with other OIG divisions. You will work in a supportive environment where ideas are valued and shared, data is explored, and colleagues are passionate about strengthening healthcare program oversight-and we are looking for someone who shares that enthusiasm and commitment.Responsibilities include but are not limited to:

• Leading oversight projects and program reviews.
• Collaborating with other OIG divisions, as needed, to conduct oversight projects and reviews.
• Conducting exploratory research and developing proposals for review projects.
• Analyzing policies and procedures with an emphasis on preventing and detecting fraud, waste and abuse of public funds.
• Conducting and contributing to meetings and presentations.
• Identifying program control weakness, potential fraud and misuse or waste of funds, in the MassHealth and HSN programs.
• Working with the Director to propose recommendations to address identified risks and develop appropriate corrective actions for areas of concern.
• Draft memoranda and summaries, letters and reports that detail findings and recommendations.QualificationsKey Abilities, Skills and Experience:
  • 4-6 years of related work experience in relevant areas of public health policy, private insurance or Medicaid oversight, healthcare policy evaluation, government-funded programs, or administration and health program evaluation related areas, such as policy analysis, budget analysis, or data analysis.
  • Demonstrated expertise in mixed methods research (MMR) to support MassHealth and Health Safety Net policy evaluation, regulatory oversight, and evidence-based decision-making. The ideal candidate will apply quantitative and qualitative research methodologies to analyze public healthcare programs for fraud, waste and abuse.
  • Demonstrated experience developing actionable policy recommendations for fraud, waste and abuse prevention and/or improved health program internal controls.
  • Ability to analyze public healthcare program effectiveness, identifying gaps and areas for improvement.
  • Proficiency in data analysis methods with a strong ability to translate research findings into actionable policy and practice, leveraging data-driven insights to inform strategic decision-making.
  • Demonstrated understanding of the Executive Office of Human Services and the MassHealth and Health Safety Net programs.
  • Demonstrated knowledge of relevant laws, regulations and policies concerning MassHealth and Health Safety Net programs.
  • Familiarity with current issues in relevant areas of Medicaid and the diverse challenges facing Massachusetts and publicly funded healthcare.
  • Strong project management skills: ability to organize, manage and prioritize projects of varying degrees of complexity and timelines, coupled with the experience to adjust project timelines due to changed circumstances.
  • Ability to independently communicate, organize and document research and effectively summarize all important topics, risks and notable issues related to projects.
  • Ability to collaborate with OIG's Data Division to critically evaluate data research and integrate program investigation or review findings into project plans and report findings and recommendations.
  • Strong presentation and communication skills, with a proven ability to deliver persuasive and impactful presentations to diverse audiences concerning complex health policy issues.
  • Demonstrated writing and editing skills (including attention to detail ensuring clarity, and accuracy), with experience to synthesize and summarize complex and highly technical information for diverse audiences including various stakeholders, policymakers, healthcare professionals, and the general public.
  • Experience presenting information visually (e.g., data visualizations; effective PowerPoint slides) as well as writing.
  • Proficient in Microsoft 365, Outlook, Word, Excel (with advanced skills for pivot tables, etc.), PowerPoint and other commonly used computer software applications.Preferred Abilities, Skills and Experience Include:
    • 4-6 years of related work experience in independent public health policy analysis, reviewing and evaluating healthcare data, healthcare program evaluation, or public health administration.
    • Bachelor's degree in public health, public policy or administration, or another related field.
    • Ability to proactively identify areas of oversight in the MassHealth and Health Safety Net program.
    • Demonstrated ability of developing health program investigation or review plan, including documenting investigative or review process.
    • Ability to manage projects and set deadlines for completion.
    • Public service experience.Salary Range: $72,000 to $83,000Other Position Information: Full time/ExemptHybrid Work Schedule:The Office of the Inspector General offers a hybrid work schedule. Under this policy, employees may request one of the following weekly hybrid schedules: 1) four days telework and one day onsite; 2) three days telework and two days onsite; 3) two days telework and three days onsite; or 4) one day telework and four days onsite. The onsite location is at OIG's Boston office and employees may work remotely the remainder of the time at a location approved by their supervisor, so long as they comply with the requirements of the Hybrid Work policy. Employees will be assigned to their onsite workspace based on their approved schedule. The approved telework location must be located within Massachusetts or within an approximately two-hour driving or train commute distance. OIG does not reimburse employees for travel to the office. In addition, the successful candidate may be required to work primarily on site in Boston during the initial training and orientation period and/or for certain positions a primarily on-site role may be necessary.We value our employees and offer benefits that support their lives and well-being, while promoting an environment focused on inclusion, flexibility, professional growth, trust and respect. The Office therefore is pleased to offer a comprehensive benefits package for its employees. The specific components and eligibility may vary based upon position, hours worked per week and other variables. Consequently, specific benefits for this position may be discussed as part of the interview and offer process.The overall benefits available include paid vacation; sick and personal leave time; health, dental and vision insurance through the Commonwealth's Group Insurance Commission; and optional pre-tax health savings accounts plans. To view the details of the various plans and the cost split between employer and employee, go to the Group Insurance Commission website.Employees also participate in the Commonwealth's state retirement plan, which may become a defined benefit plan for those who both vest and subsequently retire from state service. For more information, visit the Massachusetts State Retirement Board website.In addition, the Office provides employees the opportunity to elect life insurance, long-term disability insurance, deferred compensation savings, tuition remission pre-tax commuter account plans, along with other programs.How to applySubmit cover letter and resume via email by June 27, 2025 to:Sarah Hoover, Director of Human Resources & RecruitmentOffice of the Inspector GeneralIGO-employment@mass.govDiversity and Inclusion StatementDiversity Officer: Sarah HooverThe Officed does not tolerate discrimination or harassment on the basis of age, color, disability, gender identity, genetic information, national origin, parental status, political affiliation, race, religion, sex, sexual orientation or veteran status.The Office promotes access, inclusion and diversity for all staff, believing that these qualities are foundational components of an outstanding working environment and in keeping with its mission. The Office actively seeks to increase the diversity of its workforce and is interested in candidates whose experience and qualifications support an ongoing commitment to this core quality.Primary LocationJobJob: UnclassifiedAgencyAgency: Office of the Inspector GeneralScheduleSchedule: Full-timeShiftShift: DayJob PostingJob Posting: May 23, 2025, 5:56:16 PMNumber of OpeningsNumber of Openings: 1Salary: 72,000.00 - 83,000.00 YearlyIf you have Diversity, Affirmative Action or Equal Employment Opportunity questions or need a Reasonable Accommodation, please contact Diversity Officer / ADA Coordinator : Sarah Hoover - 6177228896Potentially Eligible for a Hybrid Work Schedule : Yes
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Keywords: Commonwealth of Massachusetts, Worcester , Lead Healthcare Policy Analyst, Healthcare , Boston, Massachusetts