IT Healthcare Consultant - Project Manager

Published: 6/14/2022

Technology

Job Description

Seeking an IT Healthcare Consultant – Project Manager to lead MMIS (Medicaid Management Information System) Operations Management. This role is responsible for leading teams that support business-critical operations, including MCO enrollment, claims and encounter processing, payment processing, and other key Medicaid support functions.

Daily Duties and Responsibilities

Oversee, coordinate, and manage operational support activities for the MMIS, Encounter Processing System, and other supporting applications, including coordination with vendors, the Office of Cyber Security, Enterprise Architecture, and other stakeholders.

Build, maintain, and lead a high-performing operational team while motivating diverse staff to achieve mission-critical objectives. Teams include Production Support, Help Desk, Interface/EDI Support, and Stakeholder Monitoring.

Oversee incident and issue management, ensuring proper documentation, tracking, escalation, and resolution of all ticket types. Ensure timely resolution of production issues.

Identify and mitigate operational risks while ensuring decisions, actions, and resolutions are thoroughly documented.

Manage internal and external escalations, ensuring issues are resolved effectively and communicated to the appropriate stakeholders. Assign work appropriately and monitor timely resolution.

Ensure compliance with security requirements and regulatory standards (CMS, SSA, etc.), and oversee remediation of audit findings and recommendations through completion.

Partner with the Contract Monitor to establish, monitor, and maintain Service Level Agreements (SLAs).

Respond promptly and professionally to internal and external inquiries.

Promote employee engagement while fostering a safe, professional, and productive work environment.

Develop, implement, monitor, and enforce Standard Operating Procedures (SOPs), and communicate deviations from established processes.

Oversee release management activities, including stakeholder communications, pre-implementation planning, readiness assessments, deployment coordination, and post-implementation monitoring.

Support change management initiatives by coordinating backlog grooming and maintenance while ensuring compliance with established governance and approval processes.

Participate in an on-call rotation and provide after-hours support for production incidents as required.

Required Skills (Ranked by Importance)

Bachelor's degree in Information Technology, Business, Healthcare Administration, or a related technical field. Equivalent experience (5+ years in business/systems analysis or computer systems development/modification) may be substituted for the degree.

5+ years of experience managing system operations and/or administrative program functions supporting healthcare claims and/or encounter processing.

5+ years of project management experience leading system implementations, upgrades, or enhancements.

3+ years of experience managing external vendors responsible for system development and support.

Ability to provide on-call and after-hours incident management support.

Strong leadership, organizational, communication, and problem-solving skills.

Preferred Skills (Ranked by Importance)

Experience managing operations for Medicaid Enterprise Systems.

Knowledge of Medicaid eligibility, enrollment, claims processing, and MMIS business processes.

Experience preparing executive presentations, reports, and operational metrics.

Experience using ticketing and incident management systems.

Experience developing and maintaining Standard Operating Procedures (SOPs) for new system implementations.

AWS Cloud certifications.

Familiarity with ITIL service management practices is a plus.