Healthcare PM (PMP) with commercial healthcare, MITA, data structures, EDI, federal certification, Medicaid payer system integration and government experience

Request ID: IN-8453-1 (910681106)

Healthcare PM (PMP) with commercial healthcare, MITA, data structures, EDI, federal certification, Medicaid payer system integration and government experience

Location: Columbia, SC
Duration: 12 Months
Remote Work Availability: 25%

REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
• At least ten years of experience in commercial healthcare.
• Experience with inner workings of cross functional projects
• Familiarity with Medicaid Information Technology Architecture (MITA) business architecture principles.
• Familiarity with standard data structures, electronic data interchange, processes and related file formats.
• Knowledge of Federal Certification requirements and processes is preferable.
• Interest, skill and ability to innovate including business processes, methods/procedures, and technology.
• Ability to effectively work and communicate, in both oral and written, with all levels of the Agency from frontline workers to Executive Staff as well as the Contractor(s).

PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
• Large business and technology integration
• Commercial integrations with Medicaid or other Government operations
• Project management
• Public Sector Government Experience
• At least five years’ experience in State Medicaid payer system integration and delivery

REQUIRED EDUCATION:
Bachelor’s Degree

REQUIRED CERTIFICATIONS:
PMP Certification

DAILY DUTIES / RESPONSIBILITIES:
The Replacement MMIS Business Integration Lead will work with the Project Director and the Lead Project Manager and will support the Project Management team to ensure the commercial principles, business goals and values of the project are met.

Duties include:
• Perform business process analysis and performance assessments for the assigned projects
• Train and mentor team members in delivering high quality business solutions that meet the overall strategy
and vision
• Build positive relationships with clients and proactively address specific needs
• Lead business design sessions within assigned modules and work streams
• Advocate and lead business integration in support of the RMMIS ASO project
• Provide backup role to the ASO product owner
• Drive, though dynamic discussion, efficient configuration of data within the core modules of RMMIS
projects
• Provide liaison role between business and IT verticals
• Ensure project deliverables for each project connect to the operational principles
• Coordinate priorities and resources between multiple projects.
• Provide updates on status and issues for all assignments
• Participate in scheduled operational meetings and routine team leads meetings
• Lead cross-functional meetings and produce business designs that integrate functionality across modules
• Facilitate sessions to effectively resolve issues if any.
• Provide recommendations of appropriate resources if necessary to ensure assignments are completed within given time and budget.
• Create and maintain key performance indicators to indicate project progress toward business integration
goals.

Experience
Administrative Verbal Communication Skills Yes 1 Expert Currently Using 6 + Years
Administrative Written Communication Skills Yes 1 Expert Currently Using 6 + Years
Education Bachelor of Science Degree Yes 1 Expert Currently Using 4 – 6 Years
MMIS – Medicaid Management Informaiton System • Experience with the Medicaid Information Technology Architecture (MITA) principles and framework Yes 1 Expert Currently Using 6 + Years
MMIS – Medicaid Management Informaiton System Commercial healthcare Yes 1 Expert Currently Using 6 + Years
MMIS – Medicaid Management Informaiton System Knowledge of Federal Certification requirements and processes Yes 1 Expert Currently Using 6 + Years
Program Management Project Management Professional (PMP) certification Yes 1 Expert Currently Using 6 + Years
Program Management Project Management experience No 1 Expert Currently Using 6 + Years
Additional Skills: The manager definitely wants to see healthcare background and a candidate with Medicaid would stick out. If the candidate does not have 10 years of commercial healthcare experience, the candidate will be rejected.

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