PCA Electronic Visit Verification Program Manager-Part Time

Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.

The MassHealth PCA EVV Program Manager is responsible for leading, coordinating, and sustaining compliance with Electronic Visit Verification (EVV) requirements within the MassHealth Personal Care Attendant (PCA) Program. This role ensures regulatory adherence while preserving access to consumer-directed care, supporting staff implementation, and mitigating operational and compliance risk. The Program Manager serves as the central EVV subject matter expert and operational lead, bridging state policy, fiscal intermediary requirements, and frontline care delivery as well presenting updates to the State on compliance and follow up.

Graduate from an accredited school of nursing, associate’s degree required, bachelor’s or higher highly preferred

• Driving your personal motor vehicle is an essential job function of this position and the following requirements apply:
  • Must possess a valid drivers’ license
  • Must attest to no disqualifiers per Driver Safety Policy
  • Must possess and provide proof of minimal state required auto insurance
  • Must have reliable transportation

• Minimum of two years of progressive experience in Personal Care Attendant programs, consumer-directed services, Medicaid operations, or Long-Term Services and Supports (LTSS).• Demonstrated experience with EVV systems, compliance monitoring, and regulatory implementation strongly preferred.• Experience managing complex member cases, non-compliance, and service terminations.• Prior supervisory, project management, or program leadership experience recommended.

In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is around $60,000 - $62,000 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities.