Senior Integrated Eligibility Analyst

The Senior Integrated Eligibility Analyst is responsible for supporting MassHealth business needs in all phases of the strategic development and implementation activities for MassHealth eligibility systems. 

The incumbent will be responsible to serve as a Subject Matter Expert (SME) on MassHealth eligibility regulations, operations and processes and to assist in identifying business process improvements, opportunities and implementation strategies related to MassHealth eligibility system operations and development. This includes, but not limited to MA21, HIX, One Health, and MMIS.  The incumbent will also be responsible for supporting implementation of Integrated Eligibility and Enrollment (IE&E) work tracks, including Common Noticing Solution (CNS) and MyServices Common Portal/Common Application. These projects may also involve business process improvements and implementation strategies supporting non-eligibility workstreams.

This position will participate in meetings to ensure policies and procedures for the agency are developed in IE&E (CNS and MyServices) and back-end eligibility (HIX, MA21 and One Health) systems.  This position will work with multi-agency project teams to develop tools, systems and processes to support strategic visions of improved member experience and optimized eligibility processes.

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

• Serve as Subject Matter Expert (SME) in MassHealth eligibility regulations, operations, and processes to support the design, development, and implementation of MassHealth eligibility systems.

• Represent MassHealth business needs and strategic vision in eligibility and supporting system development (including but not limited to: HIX, MA21, One Health, MyServices (Common Portal), Common Application, Common Noticing Solution, EDM, MMIS, etc.), ensuring system development aligns to MassHealth policies and procedures.

• Participate in multi-agency workgroup supporting the development of MyServices member portal (Common Portal) and a Common Application for MassHealth, Health Connector and other in-scope IE&E programs representing MassHealth business and operations

• Support and coordinate end-to-end implementation activities across MH business units and partner agencies for MassHealth implementation of eligibility system and IE&E work tracks, including coordination with MH policy and systems, development of operational business workflows, coordination with other MH units (ie. Learning and Development/communications, publications, legal, etc)

• Participate in Business/IT JADs teaming with IT colleagues in system developments, enhancements and expansions.

• Review and provide feedback on documents defining business and functional requirement specifications for system development (including but not limited to: HIX, MA21, One Health, MyServices (Common Portal), Common Application, Common Noticing Solution, EDM, MMIS, etc.),

• Participate in meetings with different stakeholders such as EOHHS IT teams, HIX team, MA21 team, IE&E team, One Health team, MMIS team, EDM team, EHS data warehouse, MH policy, TMSIS team, MH operations and other MH business units to assess needs and provide solutions.  Collaborate with Policy/Legal/Publications teams as needed to ensure system requirements and enhancements meet new or existing regulations.

• Represent MassHealth business in design and development of One Health eligibility system, including but not limited to integration across MA21, HIX, IE&E systems, business process redesign efforts to identify areas for streamlining policies and operational workflows, and development of a common back office/worker portal supporting both MAGI and Non-MAGI populations

• Be able to interpret and analyze data, communicate work and results to a wide variety of internal and external stakeholders.

• Support User Acceptance testing (UAT) for implementation of system development.

• Collaborate with and support the I-MEC concept of statewide standardization of practices, policies and workflows in use across all of MassHealth eligibility operations.

• Completes special projects in accordance with agency directives, including statistical and narrative reports.

• Serve as a vital component toward Excellence in Operations and customer service for members and providers.

• Use Excel and Microsoft access to analyze data.

Preferred Qualifications:                                                      

• Extensive and in-depth knowledge of MassHealth policies, programs and procedures and the ability to integrate this knowledge with new and existing IT systems.

• Familiarity with a number of complex, technical issues, systems and programs affecting Medicaid and its services to members.

• The ability to manage and sustain multiple complex relationships and ensure that lines of communication are open.

• The ability to work under significant time pressures to meet unanticipated demands.

• The ability to work effectively with teams, share information and work collaboratively to solve problems and make decisions.

• Strong communication skills.

• Experience designing and implementing data collection processes.

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) four years of full-time, or equivalent part-time, professional, administrative or managerial experience in business administration, business management or public administration the major duties of which involved program management, program administration, program coordination, program planning and/or program analysis, and (B) of which at least one year must have been in a supervisory capacity, or (C) any equivalent combination of the required experience and the substitutions below.

Substitutions:

I. A Bachelor's degree with a major in business administration, business management or public administration may be substituted for a maximum of two years of the required (A) experience.*

II. A Graduate degree with a major in business administration, business management or public administration may be substituted for a maximum of three years of the required (A) experience.*

III. A Bachelor's or higher degree with a major other than in business administration, business management or public administration may be substituted for a maximum of one year of the required (A) experience.*

*Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed.

NOTE: No substitutions will be permitted for the required (B) 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.