Deputy Director, Business & Systems Integration

2) BSI oversees external user access to the MMIS Provider Online Service Center (POSC), Robotics Processing Automation (RPA), and access to Electronic Data Interchange (EDI) transactions.

3) BSI coordinates crucial activities between business and technical staff to ensure alignment and collaboration throughout key components of the software development lifecycle (e.g., business requirements); partner with MMIS to facilitate key technical initiatives (e.g., system migrations, upgrades, etc.), and coordinate with business and technical staff to facilitate system operations issues (such as responding to outages, cyber security incidents, management of Continuity of Operations Plans [COOP])

BSI delivers on its objectives guided by a keen sense of what the business needs balanced with a thorough understanding of, and ensures compliance with, federal administrative simplification and interoperability requirements. This includes the Health Insurance Portability and Accountability Act (HIPAA) and other federal regulations (such as CMS Interoperability standards)

Reporting to the Director of BSI, MassHealth is seeking qualified applicants to apply for the exciting, hands-on position of Deputy Director of Business & Systems Integration (BSI). The Deputy Director assists the Director in all aspects of managing the BSI unit. This person is primarily responsible for day-to-day operational excellence in all BSI processes and policies and provides strategic guidance on business/technology coordination. The right candidate has the ability to 1) understand business customer needs and what that means for technical functionality, 2) deepen mutual understanding and collaboration across diverse teams, 3) drive operational efficiency, 4) develop a strategic perspective on the technology product roadmap, and 5) translate regulatory requirements into proposed business and technology changes. This is an exciting role in a team that sits at the nexus of technical innovation and product delivery at MassHealth. With great performance, this role has significant upward mobility and scope expansion opportunities.

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

The Deputy Director of BSI is also responsible for managing and maintaining positive X-functional relationships, collaborating with business staff across MassHealth, technical staff (including Virtual Gateway), MassHealth vendors, and other external entities to carry out the duties outlined below:

1) Manage user access related to the provider portal; this includes oversight of BSI staff to respond to portal permissions issues, management of the user access policy and related initiatives; management of robotics processing automation policy; identification and implementation of initiatives to strengthen policies and adhere to industry standards.

2) Oversee business management of electronic data interface (EDI) transactions, including support vendor activities, issue escalations, and future-looking strategy (such as decisions/tradeoffs around transaction formats); identify, communicate, and manage the implementation of new business processes and systems modifications to ensure data interoperability and HIPAA compliance in accordance with state and federal regulations. notify and educate MassHealth providers on upcoming initiatives and to implement requirements.

3) Manage functional integration coordination activities across MassHealth, throughout the Systems Development Life Cycle (SDLC) to ensure alignment between business and technical staff and that business needs are met. This includes the submission of functional requests, coordination of requirements validation schedules, and managing business engagement in user acceptance testing;, facilitate the prioritization of technology development requests across various business teams to support the functional roadmap.

4) Provide business leadership and management of the General subsystem within MMIS; ensure a consistent look & feel of the system , provide guidance on security protocols, facilitate key components of the cyber security incident response plan, and manage the subordinate ID security access functions. Manage other key business-based functions (e.g., the Continuity of Operations Plan (COOP), MMIS job aids, and healthcare code set validation).

5) Collaborate with the BSI Director to establish unit goals and priorities and to support large scale implementation efforts; support other duties as directed by the Director of BSI.

Required Qualifications:

Demonstrated experience in the management of business operations within a large healthcare organization (e.g., commercial payer, Medicare, Medicaid). This includes the management of provider, member or health plan policies, procedures and other operational activities (e.g., billing, security, etc.).

Demonstrated experience coordinating activities between business and technical staff throughout the Systems Development Life Cycle (SDLC) to support and/or lead the implementation of functional requirements.

knowledge of the federally mandated Health Insurance Portability and Accountability Act (HIPAA) healthcare transactions, interoperability standards, and other Electronic Data interchange (EDI) industry standard best practices.

Excellent communication, presentation, and interpersonal skills with the ability to effectively collaborate with diverse teams, stakeholders, and communicate across all levels of a healthcare organization (staff level through senior level management).

Ability to manage and convey complex issues and concepts in simple, easy to understand language, within presentations, documentation, and other standard forms of communication to facilitate issue resolution and education

Strong problem-solving skills and the ability to analyze issues, think through problems, organize information, key factors and underlying causes, and identify & implement resolution approaches.

Ability to work cooperatively with others and be part of a team.

Preferred Qualifications:

Demonstrated experience evaluating CMS administrative simplification federal mandates and related policies, assessing the impact of the mandate to a healthcare organization and documenting the findings.

Demonstrated experience managing the implementation or modification of industry standard HIPAA transactions and other large-scale systems modifications within a healthcare organization; this includes direct management and oversight of project teams and/or management of vendor resources to drive the implementation

Demonstrated experience managing COOPs, cyber security issues, robotics processing automation, and/or user access controls and policies.

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.

Qualifications

MINIMUM ENTRANCE REQUIREMENTS:

Applicants must have at least (A) five (5) years of full-time or, equivalent part-time, professional, administrative, supervisory, or managerial experience in business administration, business management, public administration, public management, clinical administration or clinical management of which (B) at least one (1) year must have been in a project management, supervisory or managerial capacity or (C) 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 (A) experience.

II. A Bachelor's degree in a related field may be substituted for two (2) years of the required (A) experience.

III. A Graduate degree in a related field may be substituted for three (3) years of the required (A) experience.

IV. A Doctorate degree in a related field may be substituted for four (4) years of the required (A) experience.

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!

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.

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.