Business Systems Manager - Eligibility and Enrollme
Job Description
Business Systems Manager – Eligibility & Enrollment
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Faulkner Consulting Group is hiring a Business Systems Manager to be the client-side owner of Rhode Island's health insurance eligibility and enrollment system. You'll join our consulting team at HealthSource RI (HSRI), the state's health insurance marketplace, where Rhode Islanders apply for and enroll in health coverage. This is a full-time, hybrid position based in downtown Providence, RI, requiring a minimum of weekly in-person work on Tuesdays and Wednesdays, and reporting to HSRI's Deputy Director of Technical Operations.
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The system, RI Bridges, is built and run by a vendor and shared with other state agencies. As the Business Systems Manager, your job is to make sure it works for HSRI. You'll turn business needs into clear requirements, decide which defects and changes matter most, sign off on testing, review what the vendor delivers, and confirm each release works once it goes live. This is not a project management or IT support role. It's for someone who sits between the business and the technology and holds a vendor accountable.
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Salary range: $95,000 – $110,000, plus FCG benefits
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Core responsibilities
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Release Management & Oversight
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- Represent HSRI in the release process from start to finish: problem management, System Integration Testing (SIT), User Acceptance Testing (UAT), go-live, and post-release validation.
- Write the business requirements and service and operational requests HSRI submits to the vendor, working with HSRI's Operations team.
- Lead post-release validation and handle ad-hoc validation requests.
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Prioritization
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- Run HSRI's process for prioritizing defects and design changes.
- Work with the other state agencies that share the system to find common priorities and make the best use of limited design hours.
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System Testing & Quality Assurance
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- Serve as one of HSRI's business contacts for SIT and UAT, alongside the UAT manager.
- Review and approve test scenarios, answer testers' questions, and approve test results.
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Vendor Oversight
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- Review and approve vendor deliverables, including design documents, release notes, data fix proposals, and test results.
- Lead weekly status calls, design sessions, and release planning meetings, and document decisions, action items, and open issues.
- Evaluate vendor change requests against HSRI's operational needs, federal requirements, and the impact on customers.
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Incident & Problem Management
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- Work with HSRI Operations to identify, report, and prioritize defects; join command center, problem management, and design sessions as needed.
- Monitor how system issues affect HSRI: track ticket volume and how long incidents stay open, escalate stalled issues to the vendor, assess which customers are affected, and brief HSRI leadership.
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Systems Integration
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- Learn how RI Bridges works with HSRI's other vendor platforms, including the call center, website, financial management system, and health insurance carriers, and serve as HSRI's go-to contact for those connections.
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- BA or BS degree
- 5+ years in a business-side systems role, such as business systems analyst, systems liaison, or functional lead, where you represented the business to a technical team or vendor
- Hands-on experience writing business or functional requirements for a large system
- Experience giving business sign-off in SIT and UAT, including reviewing test scenarios and approving results
- Experience triaging and prioritizing defects and change requests
- Experience managing a vendor relationship: reviewing deliverables, running status meetings, and pushing back when work doesn't meet requirements
- Ability to learn a complex system quickly, ask hard questions, and work through conflict calmly and respectfully
- Clear writing and speaking, including leading meetings with vendors, state agencies, and leadership
- Experience with an integrated eligibility system or another large public benefits system, such as Medicaid (MMIS), SNAP, or a state health insurance exchange
- Familiarity with the Affordable Care Act (ACA) and health insurance enrollment
- Experience working in JIRA
- Real impact: the system you oversee determines whether Rhode Islanders can get and keep health coverage.
- Real authority: you'll approve vendor work and test results on HSRI's behalf, not just track it.
- Best of both worlds: you'll be an FCG employee with FCG's benefits and colleagues, working day to day as part of the HSRI team.
- Predictable hybrid schedule: two set office days in downtown Providence and the rest from home.
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Required Qualifications
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Preferred Qualifications
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You don't need government experience to apply. If you've done this work for a health plan, a state agency, a benefits administrator, or another regulated organization that relies on a vendor-built system, we want to hear from you.
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Why This Role
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Work Environment
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The Business Systems Manager will be employed by FCG as part of our team at HealthSource RI (HSRI), the state’s marketplace for health insurance coverage. This position will work a weekly minimum of Tuesdays and Wednesdays at the HSRI offices in Providence, RI and the balance virtually from home. The incumbent must maintain normal and consistent full-time work hours, Monday – Friday.
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Faulkner Consulting Group www.faulknerconsultinggroup.com
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Faulkner Consulting Group (FCG) is an experienced health policy consulting firm focused on the intersection of public and private programs. FCG works with payers and providers to tackle health care policy projects with a fundamental commitment to client partnership. We work side by side with our clients to ensure that our policy analyses and guidance fit within the clients’ business models and capacity. We bring an analytical perspective to health policy issues with an emphasis on data-driven decision making.
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Faulkner Consulting Group is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, gender, sexual orientation, gender identity or expression, religion, national origin, marital status, age, disability, veteran status, genetic information, or any other protected status.