Lead Interface & Interoperability Analyst - MS - Medicaid

Position Details Job Description

The Mississippi Division of Medicaid (DOM) is implementing federal interoperability mandates under CMS-0057-F (Interoperability and Prior Authorization Final Rule). These requirements include implementing and maintaining Patient Access APIs, Provider Directory APIs, Provider Access APIs, Payer-to-Payer APIs, and Prior Authorization APIs based on HL7 FHIR standards.

DOM's interoperability environment uses Infor Cloverleaf as its primary integration engine, MarkLogic as its data store, and FHIR-based APIs to exchange healthcare information with managed care organizations (MCOs), providers, payers, and state and federal agencies.

The Lead Interface & Interoperability Analyst will provide senior-level technical leadership for healthcare interface operations, interoperability compliance, documentation, process improvement, document management, and a small technical team.

The contractor will report directly to the DOM CIO, Director of Solutions, and/or CTO.

Key Responsibilities

1. Healthcare Interface Management & Operations

• Manage, monitor, and maintain HL7 and FHIR-based healthcare interfaces.

• Oversee Infor Cloverleaf integration engine configuration, message routing, transformation, error handling, and performance tuning.

• Optimize existing interfaces for accuracy, reliability, throughput, and operational efficiency.

• Troubleshoot interface failures, message errors, and data exchange issues.

• Coordinate with MCOs, providers, payers, and government agencies.

2. Interoperability & Regulatory Compliance

• Support CMS-9115-F and CMS-0057-F compliance requirements.

• Support Patient Access, Provider Directory, Provider Access, Payer-to-Payer, and Prior Authorization APIs.

• Ensure alignment with HL7 FHIR, US Core, Da Vinci Implementation Guides, and USCDI.

• Coordinate with AWS, MarkLogic, Cloverleaf, and vendor teams.

• Advise IT leadership on CMS compliance requirements and timelines.

3. Interface Documentation & Process Improvement

• Develop interface specifications, data flow diagrams, mapping documents, SOPs, and message inventories.

• Assess existing healthcare interfaces and identify gaps.

• Document HIPAA-covered interfaces, including data sources, destinations, message types, frequency, and data elements.

• Implement process improvements, standardization, and automation.

• Maintain troubleshooting guides, runbooks, and knowledge bases.

4. Document Management Systems

• Implement and maintain document management systems if DOM selects a solution.

• Establish document governance, version control, access management, naming conventions, and retention policies.

• Organize interface documentation, project artifacts, and compliance records.

• Ensure compliance with HIPAA, CMS, and Mississippi records management requirements.

5. Cloverleaf Configuration Migration

• Plan and support potential Infor Cloverleaf configuration migration to new infrastructure.

• Develop migration plans, testing strategies, and rollback procedures.

• Coordinate infrastructure, network, and vendor teams.

• Validate interfaces after migration to ensure data integrity and operational continuity.

6. Team Leadership & Coordination

• Lead and coordinate a small technical contractor team.

• Assign work, provide mentorship, and review deliverables.

• Conduct interface configuration, code, and quality assurance reviews.

• Coordinate team meetings and communicate project status to leadership.

• Manage priorities, timelines, and resource escalations.

Required Skills / Experience (Mandatory)

The following requirements must be reflected in the candidate's resume to qualify for consideration.

1. 10+ years of progressive healthcare IT experience with direct, hands-on HL7 and/or FHIR healthcare interface experience. Any combination of HL7 v2.x and HL7 FHIR totaling 10+ years is acceptable.

2. Demonstrated experience with healthcare integration engines, preferably Infor Cloverleaf, Rhapsody, or equivalent enterprise integration platforms.

3. Strong understanding of HL7 v2.x, HL7 FHIR R4, CDA, CCDA, X12, and USCDI data element requirements.

4. Healthcare interoperability experience within Medicaid, managed care, hospitals, health systems, or EHR environments.

5. Experience with EHR interfaces and clinical data exchange.

6. Experience implementing and maintaining document management systems and establishing document governance processes.

7. Experience leading or supervising technical teams or contractors, including work assignment, quality review, and performance oversight.

8. Strong understanding of HIPAA Privacy and Security Rules related to healthcare data exchange.

9. Experience with interface documentation, data flow mapping, and process improvement.

10. Excellent written and verbal communication skills, including technical documentation and presentations to IT leadership.

11. Master's degree in Information Technology, Health Informatics, or a related management or technology discipline.

Preferred Skills / Experience (Not Mandatory)

1. State or federal government IT experience, preferably Medicaid, healthcare, or human services.

2. CMS-9115-F and CMS-0057-F interoperability compliance experience.

3. Infor Cloverleaf configuration, administration, and migration.

4. MarkLogic or similar NoSQL databases.

5. FHIR API development, testing, and implementation using US Core and Da Vinci Implementation Guides.

6. SMART on FHIR and OAuth 2.0 authentication.

7. HL7 certification or equivalent healthcare informatics/integration credential.

8. Enterprise document management platforms.

9. AWS cloud experience in healthcare or government.

10. PMP or similar project management certification.

11. CMS ARC-AMPE security requirements and Medicaid security compliance.

Technology Environment