Job Description

Healthcare Project Manager

Title: Healthcare Project Manager

Interview Process: 1 round, Virtual/Online

Duration of the Contract: 12 months

Possibility for Extension: Yes

Work Location: Hybrid (3 days in office, 2 days remote). Onsite for 30-90 days - schedule will turn to hybrid at the managers discretion.

Candidate Location: Candidate MUST be a SC resident or willing to relocate to SC prior to starting the role at their own expense.

DAILY DUTIES / RESPONSIBILITIES:

• Oversee, coordinate, and perform operations and support activities for MMIS, Encounter Processing System, and other supporting systems, including communication and coordination with vendors, Office of Cyber Security, Enterprise Architecture, and other stakeholders.
• Maintain an effective organizational team and motivate diverse staff to accomplish mission-critical operations and objectives. Teams provide production support, helpdesk, interface/EDI support, and stakeholder monitoring.
• Oversee incident and issue management, ensuring documentation, tracking, escalation, and resolution for all ticket types. Ensure timely resolution of production issues.
• Identify and mitigate operational issues and ensure decisions and actions are well documented.
• Handle internal and external escalations and requests, ensuring satisfactory resolution while communicating issues and outcomes to appropriate personnel. Ensure work is assigned appropriately and escalations are resolved in a timely and effective manner.
• Ensure compliance with security requirements (CMS, SSA, etc.) and monitor all findings and recommendations through completion.
• Work with contract monitors to establish and monitor Service Level Agreements (SLAs).
• Respond promptly to inquiries.
• Promote workforce engagement and maintain a safe, professional, and productive work environment for all team members.
• Implement, monitor, and enforce Standard Operating Procedures (SOPs), notifying the team when practices differ from established procedures.
• Oversee release management activities, including stakeholder communication, pre-implementation planning, readiness checks, and post-implementation monitoring.
• Support change management by coordinating backlog grooming and maintenance while ensuring compliance with required approval gates.

REQUIRED SKILLS (Ranked in Order of Importance):

• Bachelors degree in a technical, business, or healthcare-related field. Five (5) or more years of equivalent experience in business/systems analysis and/or computer systems development/modification may be substituted.
• Five (5)+ years of experience managing system operations and/or administrative program functions for claims and/or encounter processing within a healthcare environment.
• Five (5)+ years of project management experience managing system implementations and enhancements.
• Three (3)+ years of experience managing external vendors responsible for system development.
• Ability to provide incident management support on-call and after hours.
• AWS Cloud Certifications.

PREFERRED SKILLS (Ranked in Order of Importance):

• Prior experience managing operations of Medicaid Enterprise Systems (MMIS/MES).
• Ability to prepare reports and deliver presentations.
• Knowledge of Medicaid eligibility, enrollment, and MMIS domain concepts.
• Experience with ticketing software.
• Experience writing Standard Operating Procedures (SOPs) for new system implementations.

ADDITIONAL SKILLS / DUTIES:

• Excellent communication skills with staff ranging from frontline personnel to executive management.
• Ability to manage work assignments and provide team guidance.
• Experience assigning and overseeing team workloads.
• Knowledge of the System Development Life Cycle (SDLC).
• Strong documentation and process management skills.
• Excellent communication and stakeholder management abilities across all organizational levels.

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