Healthcare Project Manager - Hybrid - w2 only

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.

• 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

• Excellent communication skills with staff ranging from frontline to executive management