Job Description

Job ID: 12761

Client: South Carolina Department of Health & Human Services (SCDHHS)

Employment Type: Contract

Duration: 12 months, with possibility for extension

Interview Process: 1 Round, Virtual/Online

Work Location: Columbia, SC (1801 Main Street).

• Requirement: Candidates must be a South Carolina resident or willing to relocate to SC at their own expense prior to starting.
• Schedule: The role is Hybrid (3 days in-office, 2 days remote). However, the first 30-90 days will be 100% ONSITE before transitioning to hybrid at the manager's discretion.
  
  Work Hours: Fast-paced environment; frequently requires working outside normal business hours to support releases, on-call incident management, and unplanned incidents.

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 focuses on the MMIS systems, including replacement systems to be implemented.

The Project Manager will act as the lead for MMIS Medicaid Systems Operational Management. This role is responsible for leading teams that support business-critical operations for MCO enrollment, claims and encounter processing, payment, and other critical support functions.

• Operations Oversight: Oversee, coordinate, and perform operations and support activities for MMIS, Encounter Processing System, and other supporting systems. Manage communication and coordination with vendors, the Office of Cyber Security, Enterprise Architecture, etc.
• Team Leadership: Maintain an effective organizational team and motivate diverse staff to accomplish mission-critical operations. Oversee team workload for production support, helpdesk, interface/EDI support, and stakeholder monitoring.
• Incident Management: Oversee incident and issue management. Ensure tracking, escalation, and timely resolution for all ticket types/production issues. Handle internal and external escalations and ensure satisfactory resolution.
• Release & Change Management: Oversee release management activities, stakeholder communication, pre-implementation planning, readiness checks, and post-implementation monitoring. Support change management by coordinating backlog grooming and ensuring compliance with approval gates.
• Compliance & Risk: Ensure compliance with security standards (CMS, SSA, etc.) and monitor all findings/recommendations to completion. Identify and mitigate operational issues, ensuring decisions are well-documented.
• Vendor & SLA Management: Work with contract monitors to ensure SLAs are set, monitored, and adhered to by vendors.
• Process Improvement: Implement, monitor, and follow Standard Operating Procedures (SOPs). Alert teams when practices differ from established SOPs.

• Education/Experience: Bachelor's degree in a technical, business, or healthcare field (OR 5+ years of equivalent experience in business/systems analysis and/or computer systems development/modification).
• 5+ Years: Prior experience managing system operations and/or administrative program functions for claims and/or encounter processing in a healthcare environment.
• 5+ Years: Project management experience, specifically managing system implementations or enhancements.
• 3+ Years: Experience managing external vendors who provide system development.
• Cloud Certification: AWS Cloud Certifications are required.
• Operational Availability: Ability to provide incident management on-call and after hours.
• Core Competencies: Strong documentation and process management ability; knowledge of the System Development Life Cycle (SDLC); excellent communication skills with staff ranging from frontline to executive management.

• Prior experience managing operations of Medicaid Enterprise systems.
• Knowledge of Medicaid eligibility, enrollment, and MMIS domain concepts.
• Experience with writing Standard Operating Procedures (SOPs) for new system implementations.
• Experience utilizing enterprise ticketing software.
• Strong ability to prepare reports and deliver high-level presentations.

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