IT Developer Lead - Medicaid Management Information System (PCENT03)

ProSidian Consulting•Charlotte, NC

About The Position

ProSidian seeks a IT Developer Lead - Medicaid Management Information System to support requirements for a State Government Medicaid Management Information System (MMIS) Functional Responsibility: Serves as a technical subject matter expert, providing guidance and assistance to the Developers in addition to performing software development activities. Given the nature of the work being performed, we would expect this person to be (1) a senior-level, certified MarkLogic developer with at least 5 years of experience, or (2) a senior-level, certified Java developer with at least 7 years of experience. We would expect to have both of these resources assigned to the two teams managed by a Scrum Master so that both teams could take advantage of their respective technical expertise. Minimum Education/ Experience: Bachelor's Degree or equivalent and at least 8 years of relevant experience. Relevant Technical Certifications: MarkLogic Professional Certification or equivalent PROJECT BACKGROUND: The client is a Stake Level Department of Health and Human Services (Sponsor: Bureau of Information Systems) which is transitioning to a new Medicaid Management Information System (MMIS). The State Dept of health And Human Services (DHHS) is replacing its MMIS with a more efficient, modern system that will reduce administrative burden on providers. The State DHHS is using a step-by-step, modular process to transition from the MMIS to the Replacement Medicaid Management Information System (RMMIS). This includes the implementation of multiple system and service modules. Some of these modules have already been implemented, including the accounting and finance module, business intelligence system (BIS), pharmacy benefits administrator (PBA) module and the third-party liability (TPL) module. The project for replacement of the State’s MMIS is a major undertaking and requires major transformation of culture, processes and technology. This project also supports the State’s Medicaid Management Department’s transition from primarily a fee-for-service payer of claims towards a program and policy driver for health outcomes primarily through managed care programs. The Replacement MMIS project is a multi-year effort to replace the State’s aging MMIS and related applications with more modern capabilities along with corresponding business operations services. The goal of the RMMIS program will be incremental and modular in nature with a focus on configurable and scalable integrations, which allow for more flexibility and reduces time and cost necessary to respond to federal and state enhancements. The major sub-project components of the Replacement MMIS Program are: Administrative Services Organization (ASO) for medical claims processing Pharmacy Benefits Administrator (PBA) for pharmacy claims processing Dental Administrative Services Organization (DASO) for dental claims processing Business Intelligence System Third Party Liability Accounting and Finance – payment of medical, pharmacy, dental and MCO payments as well as other financial processing through the State SAP solution, SCEIS System Integration and Operations – a multi-vendor system integration and operations implementation The current payment process involves payment processing in the current legacy MMIS, and processing through a variety of non-integrating and manual processes. A key strategy of the RMMIS project is remove these inefficiencies and transition all Medicaid payments to the State of SC SAP solution, SCEIS. This position will primarily support the Accounting and Finance project by providing expertise in business analytics and draw from experience in previous financial SAP implementations. DAILY DUTIES / RESPONSIBILITIES The Replacement MMIS IT Developer Lead - Medicaid Management Information System will work with the Project Director and the Lead Project Manager and will support the various Project Management teams to ensure the claim solutions are coordinated with the Accounting and Finance solution. This position will serve as the Product Owner for the Accounting project for RMMIS leadership. The IT Developer Lead - Medicaid Management Information System will also provide leadership expertise in the following areas for the RMMIS team: Risk Management Issue Management Change Management With multiple implementations, this position is key to ensure these processes are centralized for RMMIS, tracked weekly and well organized. These project management processes are created and maintained by the SCDHHS PMO.

Requirements

At least five years’ experience in State Medicaid payer system integration and delivery
At least five years of experience in major SAP financial implementations
Five years of experience in risk management for large IT implementations
Experience with inner workings of cross-functional projects
Familiarity with standard MMIS data structures, electronic data interchange, processes and related file formats.
Interest, skill and ability to innovate including business processes, methods/procedures, and technology.
Ability to effectively work and communicate, in both oral and written, with all levels of the Agency from frontline workers to Executive Staff as well as the Contractor(s).
Impeccable integrity. This project will have very high visibility and will impact significant expenditures of public funds. Candidates must be confident with their abilities to make correct decisions and the courage to speak out when necessary.
Willingness and ability to effectively engage with people and organizations on a continuous basis.
Bachelor's Degree or equivalent and at least 8 years of relevant experience.

Nice To Haves

Healthcare IT Integrations with Medicaid or other Government operations
Project management
Knowledge of Federal Certification requirements and processes is preferable
Good Verbal Communication, Written & Communication Skills
Medicaid Management Information System (MMIS) experience
Bachelor’s degree in a technical or business field
2 - 4 Years Experience in major SAP financial implementations
6 + Years IT Healthcare Systems
Knowledge of Federal Certification requirements and processes
Experience working with risk management
Project Management Experience
6 + Years

Responsibilities

Serve as primary product owner for the Accounting and Finance project, ensuring project meets the goals and objectives of the business owner, the agency Chief Financial Officer (CFO)
Coordinate related business transformation activities needed with the CFO and other key staff
Coordinate project tasks and activities with the project manager
Provide project scheduling support as needed
Monitor, coordinate and resolve to conclusion cross-project integrations and dependencies which include RMMIS solution implementations and SCDHHS enterprise architecture considerations
Build positive relationships with clients and proactively address specific needs
Participate in financial and claims business design sessions within assigned modules and workstreams
Advocate and lead business analysis in support of the Accounting and Finance project and its related impacts to the ASO, PBA, DASO and MCO payments
Serve as primary risk manager for RMMIS program
Issue management
Change management
Ensure RMMIS is adhering to PMO standards and governance around project processes
Provide updates on status and issues for all assignments
Participate in scheduled operational meetings and routine team leads meetings
Lead cross-functional meetings and produce business designs that integrate functionality across modules
Facilitate sessions to effectively resolve issues if any.
Provide recommendations of appropriate resources if necessary, to ensure assignments are completed within given time and budget.