IT Healthcare Consultant - Project Manager -Consultant

Candidate Location: Candidate MUST be a SC resident or willing to relocate to SC prior to starting the role at their own expense. Scope of the project: 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. Position: IT Healthcare Consultant - Project Manager -Consultant Daily Duties / Responsibilities

• Oversee, coordinate, and perform operations and support activities for MMIS,vEncounter Processing System, and other supporting systems. To includevcommunication 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.
• 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 stakeholdermonitoring and user acceptance testing.
• 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.
• 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.
• 3+ 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.
• 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 Required/Desired Skills Candidates must have ALL the “Required” skills in order to be considered for the position. “Desired” or “Highly Desired” skills are a PLUS but may NOT be required. Skill Matrix Experience with Business workflow processes Required / Desired Amount of Experience Years of Expe Years rience 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. Required 5 Years 3+ years of prior experience managing system operations and or administrative program functions in healthcare environment, Required 3 Years 5+ years of experience in project management managing system implementations or enhancements. Required 5 Years Ability to provide incident management on call and after hours Required Prior experience managing operations of Medicaid Enterprise systems. Preferred Ability to make presentations and prepare reports. Knowledge of Medicaid eligibility, enrollment, and MMIS domain concepts Preferred Experience with ticketing software Preferred Experience with writing standard operating procedures for new system implementations. Preferred AWS Cloud Certifications. Preferred