Director Clinical Systems Engineering

Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder. Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted treatment (MAT) options to combat the growing opioid epidemic and helping people with opioid use disorder start their path to recovery. This comprehensive approach to treatment, the gold standard in care for opioid use disorder, has been shown to prevent more deaths from overdose and lead to long-term recovery. We are committed to bringing critical services to communities across the U.S. to improve access to treatment for over 26,500 patients. Our clinics are all outpatient and office-based, with clinics in Georgia, Kentucky, New Jersey, North and South Carolina, Pennsylvania, Tennessee, Texas, and Virginia. As an equal opportunity employer, we celebrate diversity and are committed to an inclusive environment for all employees and patients.

Day in the Life of a Director Clinical Systems Engineering

Key Responsibilities:

• Lead structured requirements elicitation with clinical, pharmacy, front office, revenue cycle, quality, and compliance stakeholders; facilitate workshops, workflow walkthroughs, and design sessions.
• Translate operational and clinical needs into clearly written functional and technical specifications that can be built, tested, and audited.
• Produce and maintain requirements artifacts, including current- and future-state workflow maps, user stories with acceptance criteria, configuration workbooks, requirements traceability matrices, and test scripts.
• Drive formal requirements review and sign-off prior to build; manage scope, change requests, and downstream impact analysis.
• Evaluate whether business needs are best met through configuration, integration, third-party solution, or process change, and present recommendations with cost, risk, and effort trade-offs.

• Oversee interfaces and data exchange across the application portfolio, including HL7 v2 and FHIR messaging, laboratory and toxicology results, e-prescribing and EPCS, PDMP, pharmacy and dispensing systems, and downstream reporting and analytics feeds.
• Support eligibility, claims, and remittance transaction flows (270/271, 837, 835) through the organization’s clearinghouse and payer channels in partnership with the revenue cycle team.
• Monitor interface queues and error handling; lead root-cause analysis and remediation with vendors, trading partners, and internal IT.
• Develop and validate reports and data extracts using SQL and native reporting tools; ensure data definitions are consistent across systems.

• Independently write, optimize, and troubleshoot complex SQL across clinical, pharmacy, and financial data; build and maintain operational, regulatory, and executive reporting, extracts, and dashboards.
• Own data validation for migrations and system changes, including reconciliation queries, record and field-level validation, exception reporting, and documented sign-off criteria.
• Maintain the enterprise data dictionary and source-to-target mapping; investigate data integrity issues to root cause across configuration, interfaces, and workflow.
• Present findings, methodology, and limitations clearly to clinical, operational, and executive audiences; apply minimum-necessary and 42 CFR Part 2 principles to all reporting and data sharing.

• Serve as the technical lead for site migrations onto the target EHR platform, including data extract and mapping, conversion testing, load validation, cutover planning, go-live support, and post go-live stabilization.
• Define and execute validation protocols for high-risk clinical and financial data, including dosing history, active orders, allergies, diagnoses, consents, and patient balances.
• Coordinate build, testing, and training readiness activities with implementation, help desk, and operations leadership to support wave-based go-lives.
• Document and escalate migration risks, defects, and decisions; maintain issue logs through resolution.

• Directly supervise two Clinical Applications Analysts, including work assignment, prioritization, performance management, coaching, and professional development.
• Establish and enforce intake, triage, and service level standards for application requests; balance project workload against production support escalations.
• Develop team competency in configuration, testing discipline, and documentation; build cross-coverage to reduce single-threaded dependencies.
• Partner with the help desk and implementation teams to ensure clean handoffs between project delivery and ongoing support.

• Manage day-to-day technical relationships with application vendors; review release notes, coordinate upgrades, plan regression testing, and hold vendors accountable to defect resolution timelines.
• Ensure system configuration and documentation support HIPAA, 42 CFR Part 2, DEA, SAMHSA and state OTP requirements, state licensure, CARF or other accreditation standards, and payer requirements.
• Maintain audit-ready records of configuration changes, access reviews, validation testing, and system decisions.
• Report project status, risks, decisions, and key performance metrics to the Vice President, Clinical Applications and to senior leadership.
• Perform other duties as assigned.

Technical and Functional Competencies:

• Advanced working knowledge of electronic health record and practice management system architecture, configuration, and release management.
• Demonstrated proficiency in requirements elicitation and documentation methods, including workflow mapping, user stories, functional specifications, and traceability.
• Working knowledge of healthcare integration standards and technologies, including HL7 v2, FHIR, APIs, and secure file transfer.
• Advanced, hands-on SQL proficiency required — including multi-table joins, subqueries, common table expressions, aggregation, and window functions — with the ability to independently query, validate, and reconcile data across disparate systems without analyst support.
• Working knowledge of healthcare EDI transactions and clearinghouse operations.
• Understanding of behavioral health and substance use disorder clinical workflows, documentation, and billing requirements.
• Demonstrated project management skills, including planning, resourcing, risk management, and structured status reporting to executive stakeholders.
• Proven ability to lead, develop, and hold accountable a small technical team.
• Demonstrated data fluency: able to structure an analytical question, validate the underlying data, and present the result credibly to executives. Experience with business intelligence tools and with native EHR report writers.

• Bachelor’s degree in health informatics, information systems, computer science, healthcare administration, or a related field required; Master’s degree preferred. Equivalent combination of education and directly relevant experience will be considered.
• Minimum of seven (7) years of progressive experience in clinical application configuration, systems analysis, or EHR implementation required.
• Minimum of two (2) years of direct people leadership or formal project leadership experience required.
• Demonstrated ownership of end-to-end requirements gathering for clinical or enterprise software initiatives required.
• Hands-on configuration experience with at least one enterprise EHR or practice management platform required; behavioral health, substance use disorder, or OTP platform experience strongly preferred.
• Experience supporting multi-site EHR implementation, consolidation, or data migration required.
• Working knowledge of interfaces and integration (HL7, FHIR, API, SFTP) required. Demonstrated hands-on SQL experience is required and will be assessed during the interview process.
• Knowledge of OTP and OBOT operations, including methadone and buprenorphine dispensing workflows, take-home regulations, and 42 CFR Part 2, strongly preferred.
• Experience with a healthcare clearinghouse and familiarity with revenue cycle workflows preferred.
• Professional certification such as CPHIMS, CAHIMS, PMP, Certified Scrum Product Owner, Six Sigma, or vendor-specific application certification preferred.
• Ability to travel to clinic sites as required to support implementations, go-lives, and workflow assessments.
• Experience building reports, extracts, or dashboards used by operational or executive leadership required; experience owning data validation for a system conversion strongly preferred.

• Medical, Dental, and Vision Insurance
• PTO
• Variety of 401K options including a match program with no vesture period
• Annual Continuing Education Allowance (in related field)
• Life Insurance
• Short/Long Term Disability
• Paid maternity/paternity leave
• Mental Health Day
• Calm subscription for all employees