Location
Columbia, SC (Hybrid - Required onsite 100% for the first 30 to 90 days, transitioning to hybrid 3 days onsite and 2 days remote at the manager's discretion. Candidates must reside in South Carolina or be willing to relocate prior to starting at their own expense.)
Experience Level
Senior Level (5 or more years of experience)
Role Overview
This IT Healthcare Consultant and Project Manager position serves within the bureau of systems management at a state healthcare agency. This role leads teams that support business-critical operations for managed care organization (MCO) enrollment, claims and encounter processing, payment systems, and MMIS (Medicaid Management Information System) operations, including upcoming system replacements. Operating on a 12-month contract with a high possibility of extension, the consultant oversees system implementations, release management, security compliance, and external development vendors. Due to the critical nature of these healthcare platforms, after-hours and on-call support will be required to manage production releases and unplanned incidents.
Key Responsibilities
Operations & MMIS System Management
- Oversee, coordinate, and execute daily operations and support activities for MMIS, Encounter Processing Systems, and related healthcare database applications.
- Lead and motivate cross-functional teams of five or more technical staff providing production support, helpdesk services, interface/EDI support, and stakeholder monitoring.
- Partner with cybersecurity, enterprise architecture, and infrastructure teams to ensure seamless data flows and security posture.
- Establish, implement, and govern Standard Operating Procedures (SOPs) across all active IT operational and support workflows.
Project & Vendor Management
- Lead enterprise project management initiatives focused on system implementations, modernizations, and platform enhancements.
- Manage and oversee external technology vendors responsible for system development, ensuring delivery schedules and technical standards are maintained.
- Work closely with contract monitoring teams to define, monitor, and enforce Service Level Agreements (SLAs) with external providers.
Incident, Release, & Change Management
- Oversee comprehensive release management processes, including pre-implementation readiness checks, post-implementation monitoring, and stakeholder communications.
- Manage incident, change, and issue ticketing systems, ensuring thorough documentation, escalation tracking, and rapid resolution of production-impacting bugs.
- Provide change management support by directing backlog grooming and enforcing compliance with established technical approval gates.
- Participate in on-call and after-hours incident management rotation to address critical production issues and support system releases.
Compliance & Governance
- Ensure system and operational compliance with federal security frameworks (including CMS and SSA) and monitor all findings to successful remediation.
- Act as the escalation point for both internal and external requests, resolving operational issues and reporting metrics to leadership.
- Foster a highly professional, collaborative, and safe work environment for technical teams.
Required Qualifications
- 5 or more years of experience managing system operations or administrative program functions for claims or encounter processing within a healthcare environment.
- 5 or more years of project management experience managing enterprise system implementations or large-scale technical enhancements.
- 3 or more years of experience managing and directing external vendors who provide system and application development.
- Ability to provide on-call and after-hours incident management support to resolve critical system issues.
- Bachelor's degree in a technical, business, or healthcare-related field (or 5 or more years of equivalent professional experience in business/systems analysis or software development).
- Ability to successfully pass a criminal background check, drug screening, and sign a state confidentiality agreement.
Preferred Qualifications
- Prior experience managing operations for Medicaid Enterprise systems (MMIS).
- Professional certifications such as AWS Cloud Certifications.
- Deep functional knowledge of Medicaid eligibility, enrollment, and MMIS domain concepts.
- Direct experience utilizing incident management and ticketing software.
- Experience writing detailed Standard Operating Procedures (SOPs) for net-new system implementations.
- Experience preparing analytical reports and delivering technical presentations to project management.
Core Skills & Attributes
- Excellent communication skills with the ability to convey complex technical concepts to staff ranging from frontline analysts to executive management.
- Strong leadership capabilities to manage team workloads, provide technical guidance, and allocate resources effectively.
- Comprehensive knowledge of the system development lifecycle (SDLC) and modern release patterns.
- Exceptional process management, organization, and documentation skills.
Flexible work from home options available.
