SCOPE OF THE PROJECT:
SCDHHS 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.
DAILY DUTIES / RESPONSIBILITIES:
-
Oversee, coordinate, and perform operations and support activities for MMIS, Encounter Processing System, and other supporting systems. To include communication and coordination with vendors, Office of Cyber Security, Enterprise Architecture, etc.
-
Maintains an effective organizational team and motivates diverse staff to accomplish mission critical operations and objectives. These teams provide production support, helpdesk, interface/EDI support, and stakeholder monitoring and
-
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.
-
Works with contract monitor to ensure SLAs are set and monitored.
-
Responds promptly to inquiries.
-
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.
REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
-
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.
-
5+ years of prior experience managing system operations and or administrative program functions for claims and/or encounter processing in healthcare environment.
-
5+ years of experience in project management – managing system implementations or enhancements.
-
3+ years of experience manage external vendors who provide system development.
-
Ability to provide incident management on call and after hours
-
AWS Cloud Certifications
PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
-
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.
ADDITIONAL SKILLS/DUTIES:
-
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
Benefits at IntelliBee
-
Long-Term Stability: Join us on a multi-year opportunities with room to grow.
-
Comprehensive Health Coverage: Access quality healthcare benefits to keep you and your family well.
-
Future Planning: Enroll in our 401(k) program and invest in your financial security.
-
GC Assistance: We support immediate Green Card processing, if required.
