Business & Systems Integration Manager

The MassHealth Business & Systems Integration Team is responsible for facilitating the implementation of administrative simplification-based state & federal mandates, and related initiatives. This includes the Health Insurance Portability and Accountability Act (HIPAA) mandates and the ongoing maintenance, support, and compliance of the Council for Affordable Quality Healthcare (CAQH) Committee on Operating Rules for Information Exchange (CORE) requirements.

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 those mandates and initiatives and will be responsible for coordinating cross-functional operational, compliance, communication, and systems support activities related to MassHealth administrative simplification initiatives, Medicaid Management Information System operations, 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):

Project & Operational Coordination:

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.

Stakeholder Communication & Engagement:

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.

Compliance, Standards & Industry Coordination:

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.

Vendor, Testing & Systems Support:

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.

Documentation, Governance & Team Support:

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 MMIS and other agency initiatives.

Preferred Qualifications:

Demonstrated experience facilitating or coordinating business activities through the Systems Development Life Cycle (SDLC).

Proven ability to coordinate and collaborate with multiple stakeholders such as business and technical staff to implement system functionality.

Demonstrated knowledge and understanding of Health Insurance Portability and Accountability Act (HIPAA) healthcare transactions (e.g. 837, 270/271).

Demonstrated experience with reviewing and/or creating HIPAA Companion Guides or similar documentation.

Demonstrated experience in developing and managing project plans for medium to large-scale projects that include the delivery of systems functionality.

Demonstrated ability to identify, monitor and coordinate project risks, issues & activities through resolution across multiple work streams.

Demonstrated ability to effectively communicate across all levels of an organization (staff level through senior level management).

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.

Questions or issues regarding access/login credentials to MassCareers, please contact the Mass HR ESC at 617-979-8500.

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.

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.