Business & Systems Integration Manager

Summary of the Position:

The Business & Systems Integration (BSI) Team serves as the primary liaison between MassHealth business areas and technical partners, ensuring the Medicaid Management Information System (MMIS) and Electronic Data Interchange (EDI) operations support business objectives and comply with federal and state requirements. The team leads the implementation and governance of HIPAA electronic transactions, administrative simplification initiatives, companion guides, trading partner communications, and the business adoption of new federal transaction standards.

MassHealth is seeking qualified applicants for the position of Business & Systems Integration Manager. This position is integral to the successful planning, development, and implementation of these mandates and initiatives and will be responsible for coordinating cross-functional operational, compliance, communication, and systems support activities related to MassHealth administrative simplification initiatives, the MassHealth Medicaid Management Information System, and other agency strategic priorities. The role serves as a liaison among business, technical, vendor, and external stakeholder groups to support project implementation, operational readiness, compliance activities, and ongoing program support.

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

• Coordinate and support cross-functional initiatives and operational activities by facilitating project planning, implementation, stabilization, and operational readiness efforts across business, technical, and vendor teams. Support the execution of agency priorities through effective coordination, issue resolution, tracking, and follow-up activities.
• Support the development, review, coordination, and dissemination of internal and external communications related to agency initiatives, operational changes, compliance activities, and system implementations. Facilitate stakeholder engagement and ensure communication materials, presentations, and related resources are accurate, timely, and appropriately reviewed and approved.
• Support agency compliance with applicable federal mandates, HIPAA administrative simplification requirements, and industry standards by coordinating related activities, monitoring regulatory and industry developments, and facilitating implementation of operational and system changes as required.
• Coordinate activities related to vendor management, trading partner engagement, testing support, and operational system readiness to support successful implementation and ongoing maintenance of agency systems and business processes. Collaborate with business and technical teams to support validation, issue resolution, and operational continuity activities.
• Maintain and support organizational governance processes, operational documentation, repositories, and administrative support functions to ensure materials are accurate, organized, accessible, and appropriately maintained.
• Provide guidance and operational support to staff and teams contributing to the MassHealth Medicaid Management Information System and other agency initiatives.
• Monitor project activities, identify risks and issues, coordinate resolution efforts, and provide regular updates to stakeholders to support successful project outcomes.
• Collaborate with cross-functional teams to improve business processes, strengthen operational efficiency, and support the successful implementation of strategic initiatives.
• Perform other duties as assigned.

Preferred Qualifications:

• Healthcare experience is a requirement. 
• Experience working with vendors, trading partners, or external business partners to support system implementations or operational readiness.
• Demonstrated experience facilitating or coordinating business activities through the Systems Development Life Cycle (SDLC), including business requirements, testing, implementation, and operational readiness.
• Proven ability to coordinate and collaborate with cross-functional stakeholders, including business, technical and external vendor partners to implement business processes or system functionality.
• Demonstrated knowledge and understanding of Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification requirements and electronic healthcare transactions (i.e., ASC X12 837, 270/271, 276/277, 278, 835, or related standards).
• Demonstrated experience supporting Electronic Data Interchange (EDI) operations, trading partner activities, HIPAA compliance initiatives, or related business implementation efforts.  Experience reviewing and/or creating HIPAA Companion Guides, implementation guides, business requirements, or other operational and technical documentation.
• Demonstrated experience coordinating medium- to large-scale projects involving business operations, systems implementation, regulatory compliance or technology initiatives.
• Demonstrated ability to identify, assess and coordinate the resolution of project risks, issues, dependencies, and action items across multiple workstreams.
• Excellent written and verbal communication skills, with demonstrated ability to communicate effectively with technical teams, business stakeholders, vendors, and executive leadership.
•  Strong analytical, organizational, facilitation, and problem-solving skills, with the ability to manage multiple priorities and support complex initiatives in a collaborative environment.

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.

About MassHealth:

The mission of MassHealth is to improve the health outcomes of our diverse members, their families, and their communities by providing access to integrated health care services that sustainably promote health, well-being, independence, and quality of life.

For more information about our agency and programs please visit: www.mass.gov/masshealth

Pre-Offer Process:

A criminal and tax history background check will be completed on the recommended candidate as required by the regulations set forth by the Executive Office of Health and Human Services prior to the candidate being hired. For more information, please visit http://www.mass.gov/hhs/cori

Education, licensure, and certifications will be verified in accordance with the Human Resources Division’s Hiring Guidelines.

Education and license/certification information provided by the selected candidate(s) is subject to the Massachusetts Public Records Law and may be published on the Commonwealth’s website.

If you require assistance with the application/interview process and would like to request an ADA accommodation, please click on the link and complete the Reasonable Accommodation Online Request Form.

For questions, please contact the Office of Human Resources at 1-800-510-4122 and select option #4.

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.

Want the specifics? Explore our Employee Benefits and Rewards!

An Equal Opportunity / Affirmative Action Employer.  Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.

The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law.  Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements.  We encourage individuals who believe they have the skills necessary to thrive to apply for this role.