IT Healthcare Consultant - Project Manager

Job Title: IT Healthcare Consultant - Project Manager - Consultant
Job ID: 13411
Client: State of SC (South Carolina Department of Health & Human Services (SCDHHS))
Location: Columbia, SC (Fully Onsite for 30-90 days, then hybrid at manager's discretion. Candidate MUST be a SC resident or willing to relocate to SC prior to starting).
Duration: 12 months (Possibility for Extension: Yes)
Interview Process: 1 round, Virtual/Online I. Company / Department Culture

The South Carolina Department of Health & Human Services (SCDHHS) is the State Medicaid Agency for South Carolina. This position is located within the Bureau of Medicaid Systems and will focus on the MMIS systems, including replacement systems to be implemented. The environment is fast-paced, and this position will frequently require working outside of normal business hours to support releases and unplanned incidents.

Note: This is a new position. Do not submit resources that were previously interviewed for posting 12761.

II. Scope of the Project

SCDHHS is looking for an IT Healthcare Consultant - Project Manager 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.

III. 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.
• Conduct vendor management including monitoring service level agreements (SLAs).
• Design and develop desk aides and process flows for new and existing service lines.
• Train team members to use desk aides, process flows, and ticketing systems to perform operational support.
• Maintain an effective organizational team and motivate diverse staff to accomplish mission-critical operations and objectives. Teams provide production support, helpdesk, interface/EDI support, stakeholder monitoring, and user acceptance testing.
• Oversee incident and issue management. Ensure 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; ensure they are satisfactorily resolved, communicating issues and outcomes to appropriate personnel. Ensure work is assigned appropriately.
• Ensure compliance with security (CMS, SSA, etc.) and monitor all findings and recommendations to completion.
• Promote workforce engagement and a safe, professional, and productive work environment for all team members.
• Implement, monitor, and follow Standard Operating Procedures (SOPs) and alert the team when practice differs from SOP.
• Oversee 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.

IV. Required Skills

• 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).
• 3+ years of prior experience managing system operations and/or administrative program functions in a healthcare environment.
• 5+ years of experience in project/program management managing system implementations or enhancements.
• Ability to provide incident management on-call and after hours.

V. Preferred Skills

• 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.

VI. 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 the system development lifecycle (SDLC).
• Strong documentation and process management ability.