Project Manager

About the Role

This position will focus on the MMIS systems, including replacement systems to be implemented. The work is very fast paced, and this position will frequently be required to work outside of normal business hours to support releases and unplanned incidents.

Scope

The client is looking for an IT Healthcare Consultant - Project Manager who will be the lead for MMIS Medicaid Systems Operational Management. This position will lead teams that support business-critical operations for MCO enrollment, claims and encounter processing and payment, and other support functions.

Responsibilities

• Oversee, coordinate, and perform operations and support activities for MMIS, Encounter Processing System, and other supporting systems, including communication and coordination with vendors, Office of Cyber Security, Enterprise Architecture, etc.
• Conduct vendor management including monitoring service level agreements.
• Design and develop desk aides and process flows for new and existing service lines.
• Train team members to use desk aides, process flows, and ticketing system to perform operational support.
• Maintain an effective organizational team and motivate diverse staff to accomplish mission critical operations and objectives. These teams provide production support, helpdesk, interface/EDI support, and stakeholder monitoring and user acceptance testing.
• Oversee incident and issue management. Ensure documentation, tracking, escalation and resolution for all ticket types. Ensure timely resolution of production issues.
• Identify and mitigate operational issues and ensure decisions and actions are well-documented.
• Handle internal and external escalations and requests and ensure they are satisfactorily resolved, communicating issues and outcomes to appropriate personnel.
• Ensure work is assigned appropriately and escalations are resolved in a timely and effective manner.
• Ensure compliance with security (CMS, SSA, etc.) and monitor all findings and recommendations to completion.
• Promote workforce engagement and a safe, professional, and productive work environment for all team members.
• Implement, monitor and follow Standard Operating Procedures and alert team when practice differs from SOP.
• Oversee release management activities: stakeholder communication, pre-implementation planning, readiness checks, and post-implementation monitoring.
• Provide support to change management by performing and coordinating backlog grooming and maintenance and ensuring compliance with appropriate approval gates.

Required Qualifications

• Bachelor's degree in a technical, business, or healthcare field (5+ years of equivalent experience in business/systems analysis and/or computer systems development/modification may be substituted).
• 3+ years of prior experience managing system operations and/or administrative program functions in a healthcare environment.
• 5+ years of experience in project/program management managing system implementations or enhancements.
• Ability to provide incident management on call and after hours.

Preferred Qualifications

• Prior experience managing operations of Medicaid Enterprise systems.
• Ability to make presentations and prepare reports.
• Knowledge of Medicaid eligibility, enrollment, and MMIS domain concepts.
• Experience with ticketing software.
• Experience with writing standard operating procedures for new system implementations.
• AWS Cloud Certifications.

Additional Skills

• Excellent communication skills with staff ranging from frontline to executive management.
• Ability to manage work and provide guidance.
• Experience assigning/overseeing team workload.
• Knowledge of system development lifecycle.
• Strong documentation and process management ability.