Healthcare Consultant – Project Manager - Contract - Columbia, SC

SUNSHINE ENTERPRISE USA LLC•Columbia, SC

4d•Onsite

About The Position

Seeking an experienced IT Healthcare Consultant – Project Manager to lead MMIS Medicaid Systems Operational Management. The selected candidate will lead teams supporting business-critical operations, including MCO enrollment, claims and encounter processing, payment, production support, helpdesk, interface/EDI support, stakeholder monitoring, and user acceptance testing. The Project Manager will oversee operational activities, vendor management, incident and issue management, release management, change management, and compliance activities while ensuring critical Medicaid systems remain stable, secure, and operational.

Requirements

3+ years of experience managing system operations and/or administrative program functions in a healthcare environment.
5+ years of experience in project/program management, including managing system implementations or enhancements.
Experience providing incident management, on-call, and after-hours support.
Strong knowledge of system development lifecycle and operational processes.
Strong documentation and process management skills.
Experience managing team workloads and providing operational guidance.
Excellent communication skills with staff ranging from frontline personnel to executive management.

Nice To Haves

Prior experience managing operations of Medicaid Enterprise Systems.
Knowledge of Medicaid eligibility, enrollment, claims, encounters, and MMIS domain concepts.
Ability to prepare management reports and deliver presentations.
Experience working with ticketing systems/software.
Experience writing Standard Operating Procedures (SOPs) for new system implementations.
Experience with AWS Cloud environments or AWS Cloud Certifications.
Experience managing healthcare IT vendors and Service Level Agreements.
Experience with release, change, incident, and production management processes.

Responsibilities

Oversee, coordinate, and perform operations and support activities for MMIS, Encounter Processing Systems, and other supporting systems.
Coordinate with vendors, Office of Cyber Security, Enterprise Architecture, and other stakeholders.
Manage vendors and monitor Service Level Agreements (SLAs) to ensure contractual obligations are met.
Design and develop desk aides, standard operating procedures, and process flows for new and existing services.
Train team members on desk aides, process flows, ticketing systems, and operational support procedures.
Lead and maintain effective operational teams supporting production, helpdesk, interface/EDI, stakeholder monitoring, and UAT activities.
Oversee incident and issue management, including documentation, tracking, escalation, and resolution.
Ensure timely resolution of production issues and operational incidents.
Identify and mitigate operational risks, issues, and dependencies.
Manage internal and external escalations and ensure appropriate communication and resolution.
Assign work appropriately and monitor team workload and performance.
Ensure compliance with CMS, SSA, security, and other applicable requirements.
Monitor security findings and recommendations through completion.
Implement, monitor, and enforce Standard Operating Procedures (SOPs).
Identify and communicate situations where operational practices differ from established procedures.
Oversee release management activities, including stakeholder communication, pre-implementation planning, readiness checks, and post-implementation monitoring.
Support change management activities, including backlog grooming, maintenance, and compliance with required approval gates.
Provide regular status updates, reports, and presentations to stakeholders and management.
Provide on-call and after-hours incident management support when required.