About the Role:As a senior consultant- project manager in the Data Services and Management practice area, you will collaborate with team members to lead the planning, execution and delivery of projects for the "Claims & Financial" portfolio within eMedNY, the Medicaid Management Information System (MMIS).
Serving as a project manager, your day-to-day role as a NYSTEC consultant will include ensuring that projects completed by the vendors for claims adjudication, financial reporting, and related system initiatives in the Claims Processing and Financial modules are delivered on time, within scope, and within budget while maintaining compliance with NYS requirements and federal and state Medicaid regulations.
Key Responsibilities- Lead end-to-end project management for initiatives within the "Claims & Financial" portfolio, ensuring alignment with project objectives, timelines, and regulatory requirements.
- Manage project scope, schedules, budgets, risks, and deliverables in accordance with established project management methodologies and the Software Development Life Cycle (SDLC).
- Coordinate cross-functional teams, including business analysts, developers, testers, vendors, and subject matter experts, to support successful project execution.
- Oversee initiatives involving claims processing, adjudication, pricing updates, provider payments, financial transactions, reconciliation, and reporting.
- Develop an understanding of the eMedNY system, Centers for Medicare and Medicaid Services (CMS) guidelines, and applicable state and federal regulations to support compliant project implementation.
- Assess the impact of system changes on business operations, technology, policies, training, communications and provider experience.
- Collaborate with internal and external stakeholders to establish priorities, resolve challenges, and ensure alignment on project objectives.
- Facilitate project meetings, steering committee and executive briefings, and status updates, communicating progress, risks, and recommendations to leadership.
- Identify and mitigate project risks, manage stakeholder expectations, and escalate critical issues as needed.
- Support quality assurance activities, including deliverable reviews, user acceptance testing (UAT), defect resolution, and implementation readiness.
- Ensure project deliverables and system enhancements meet established quality standards and applicable regulatory and compliance requirements.
About you:Required Qualifications- Knowledge of Medicaid claims adjudication processes, provider reimbursement methodologies, and financial reporting or a demonstrated ability to learn the subject area quickly.
- Proficiency in project management tools (e.g., Microsoft Project, Jira, Azure DevOps).
Preferred/Desired Qualifications
- Project Management Professional (PMP), Certified Associate in Project Management (CAPM), or equivalent project management certification.
- Experience with CMS requirements.
- Experience with project management methodologies in a government IT setting.
- Three years in healthcare IT or Medicaid/MMIS environments.
Education and Experience
- A bachelor's degree in business administration, information technology, healthcare administration and five years of related experience in project management.
- An equivalent combination of advanced education, training, and experience will be considered.
The target base salary for this position is $84,497.00 to $109,846.00 per year. When determining compensation, we analyze and carefully consider several factors, including skill set, experience, location, and job-related qualifications.
Learn more about NYSTEC by visiting www.nystec.com.
