Project Manager MMIS Medicaid - contract - Columbia, SC

SUNSHINE ENTERPRISE USA LLC•Irmo, SC

1d•Hybrid

About The Position

Seeking an experienced IT Healthcare Consultant – Project Manager to serve as the lead for MMIS Medicaid Systems Operational Management. The consultant will oversee teams responsible for supporting business-critical Medicaid operations, including MCO enrollment, claims and encounter processing, payment processing, production support, and related healthcare system functions. The consultant will coordinate with internal teams, external vendors, cybersecurity teams, enterprise architecture teams, and business stakeholders to ensure reliable system operations, incident resolution, compliance adherence, and continuous process improvement.

Requirements

5+ years of experience managing healthcare system operations or administrative programs.
5+ years of experience supporting claims and/or encounter processing systems.
5+ years of project management experience managing system implementations, enhancements, or operational projects.
3+ years of experience managing external vendors providing system development/support services.
Experience with incident management, production support, and issue escalation.
Ability to participate in after-hours/on-call support when required.
Strong knowledge of Software Development Life Cycle (SDLC).
Excellent documentation, communication, and stakeholder management skills.
Bachelor’s degree in Technical, Business, Healthcare, or related field. (5+ years of equivalent experience in business/systems analysis or application development may substitute.)

Nice To Haves

Experience managing Medicaid Enterprise Systems (MES/MMIS) operations.
Knowledge of Medicaid eligibility, enrollment, claims, and encounter processing concepts.
Experience preparing executive presentations and operational reports.
Experience with ticketing systems.
Experience creating SOPs and operational documentation.
AWS Cloud Certifications

Responsibilities

Lead and oversee operational support activities for MMIS, Encounter Processing Systems, and supporting healthcare applications.
Manage teams supporting production operations, helpdesk functions, interface/EDI support, and stakeholder monitoring.
Ensure operational processes meet business objectives and service-level expectations.
Manage production incidents, issues, escalations, and resolution activities.
Ensure incidents are properly documented, tracked, escalated, and resolved within required timelines.
Identify operational risks and implement mitigation strategies.
Maintain documentation of decisions, actions, and resolutions.
Coordinate with external vendors, cybersecurity teams, enterprise architecture teams, and business stakeholders.
Manage vendor deliverables, communications, and issue resolution.
Ensure effective collaboration between technical and business teams.
Support system implementations, enhancements, and operational improvements.
Oversee release management activities, including stakeholder communication, implementation planning, readiness assessments, and post-production monitoring.
Support change management activities, backlog grooming, and approval processes.
Ensure compliance with CMS, SSA, security policies, and organizational standards.
Monitor security findings and ensure corrective actions are completed.
Develop, maintain, and enforce Standard Operating Procedures (SOPs).
Identify opportunities for operational improvement.
Provide leadership, guidance, and workload management for support teams.
Promote collaboration, accountability, and effective communication.
Support a professional and productive team environment.