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
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.
" AWS Cloud Certifications
