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).