Description:
SCOPE OF THE PROJECT:
The client is looking for an IT Healthcare Consultant - Project Manager - Consultant 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.
DAILY DUTIES / RESPONSIBILITIES:
Oversee, coordinate, and perform operations and support activities for MMIS, Encounter Processing System, and other supporting systems. To include communication and coordination with vendors, Office of Cyber Security, Enterprise Architecture, etc.
Maintains an effective organizational team and motivates diverse staff to accomplish mission critical operations and objectives. These teams provide production support, helpdesk, interface/EDI support, and stakeholder monitoring and
Oversee incident and issue management. Ensures documentation, tracking, escalation and resolution for all ticket types. Ensures timely resolution of production issues.
Identifies and mitigates operational issues and ensures decisions and actions are well-documented.
Handles internal and external escalations and requests and ensures they are satisfactorily resolved, communicating issues and outcomes to appropriate personnel. Ensures work is assigned appropriately and escalations are resolved in a timely and effective manner.
Ensures compliance with security (CMS, SSA, etc.) and monitors all findings and recommendations to completion.
Works with contract monitor to ensure SLAs are set and monitored.
Responds promptly to inquiries.
Promotes workforce engagement and a safe, professional, and productive work environment for all team members
Implements, monitors and follows Standard Operating Procedures and alerts team when practice differs from SOP.
Oversees 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 SKILLS (RANK IN ORDER OFIMPORTANCE):
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.
5+ years of prior experience managing system operations and or administrative program functions for claims and/or encounter processing in healthcare environment.
5+ years of experience in project management - managing system implementations or enhancements.
3+ years of experience manage external vendors who provide system development.
Ability to provide incident management on call and after hours
PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
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/DUTIES:
-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
Notes:
Hybrid (3 days in office, 2 days remote). Onsite for 30-90 days - schedule will turn to hybrid at the managers discretion.
