Project Manager (PMP) with ICD-10/ICD-9, Mainframes, QA Testing, SDLC and MITA/MMIS/medicaid/healthcare/claims processing experience


Project Manager (PMP) with ICD-10/ICD-9, Mainframes, QA Testing, SDLC and MITA/MMIS/medicaid/healthcare/claims processing experience

Location: Columbia SC
Duration: 12 Months

• Experience with managing the implementation of major (multi-million dollar) projects.
• Knowledge of Medicaid Information Technology Architecture (MITA) principles and framework.

• Knowledge of Federal Certification requirements and processes is preferable.
• Knowledge of Medicaid.
• 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).
• Impeccable integrity. This project will have very high visibility and will impact significant expenditures of public funds. Candidates must be confident with their abilities to make correct decisions and the courage to speak out when necessary.
• Willingness and ability to effectively engage with people and organizations on a continuous basis. PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
• Provider Credentialing
• Accounting & Finance
• ICD 9 & ICD 10 Experience

• Analytics
• Integration

• Quality Assurance
• Claims Processing

Bachelor Degree, preferred


PMP Certification, preferred

The ICD-10 Project Manager is responsible for managing cost, schedule, scope, and quality of all activities and deliverables on the project. The PM will manage a mid-sized team, and will oversee vendor support activities associated with the project.

Duties include:

• Building a project plan and executing to that plan.
• Determining and managing project expenses within the allocated budget.
• Managing project risks and issues.

• Directing the activities of Business Analysts/Subject Mater Experts (SMEs) in the development of project documents.

• Manage the implementation once a vendor is selected, as well as, manage the vendor relationship.
• Ensure that all deliverables and activities are completed with high quality and in a timely fashion.
• Reporting on project status and strategies orally and in writing to the Project Management Office Director, project partners and other major initiative projects leads.
• Providing advice on procurement and implementation strategies.

• Coordinating with outside entities, including vendors for other systems/services, providers, professional associations, and other State agencies.

• Other duties as assigned.

Job Description: ICD-10 represents a major improvement to medical coding practices (diagnosis and procedure codes) that impact both providers and payers requiring significant changes to related health care policies, business processes and information systems. ICD-10-CM will completely replace ICD-9-CM for dates of service on or after October 1, 2014; and ICD-10-PCS will replace ICD-9-CM for dates of discharge on or after October 1, 2014.

Responsible for managing ICD-10 IT program consisting of multiple projects. Develops the program strategy, supporting business case and various enterprise-wide high-level project plans. Ensures integration of projects and adjusts project scope, timing, and budgets as needed, based on the needs of the business. Communicates with IT leadership, business leadership and IT Business Consultants to communicate program strategy, direction and changes. Responsible for delivering all projects contained in the IT project portfolio on time, within budget and meeting the strategic and business requirements. Responsible for tracking key project milestones and recommending adjustments to Project Managers. Partners with senior leadership of the business community to identify and prioritize opportunities for utilizing IT to achieve the goals of the enterprise. Must possess extensive knowledge and expertise in the use of Project Management methodologies and tools. This is a single or multiple incumbent(s) position that typically exists in a small to medium size enterprise with multiple project managers, project leaders and/or project support staff as direct reports.

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