About The Position

The client is 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.

Requirements

  • 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 in healthcare environment.
  • 5+ years of experience in project/program management – managing system implementations or enhancements.
  • Ability to provide incident management on call and after hours

Nice To Haves

  • 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
  • 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

Responsibilities

  • Oversee, coordinate, and perform operations and support activities for MMIS, Encounter Processing System, and other supporting systems.
  • 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.
  • 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.
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