IT Healthcare Consultant – Project Manager – Consultant

IT Healthcare Consultant – Project Manager – Consultant

Location:

Columbia, SC 29210 Work Arrangement:
Hybrid – 3 days onsite and 2 days remote Initial Onsite Requirement:
Candidate may be required to work fully onsite for the first 30–90 days. The hybrid schedule will begin at the manager's discretion. Contract Duration: 12 months Interview Process:
One virtual interview Candidate

Location:

Candidate must currently reside in South Carolina or be willing to relocate to South Carolina at their own expense before starting.

This position will focus on the Medicaid Management Information System, including existing MMIS platforms and replacement systems being implemented. The consultant will lead teams supporting business-critical Medicaid operations, including Managed Care Organization enrollment, claims and encounter processing, payment operations, production support, help desk services, EDI/interface support, and stakeholder monitoring. The environment is fast-paced, and the selected consultant must be available to support production releases, critical incidents, and unplanned issues outside normal business hours when required.

• Lead operational management and production-support activities for MMIS, the Encounter Processing System, and related Medicaid systems.
• Coordinate activities with external vendors, the Office of Cyber Security, Enterprise Architecture, business stakeholders, and technical teams.
• Lead and motivate teams responsible for production support, help desk operations, EDI and interface support, and stakeholder monitoring.
• Oversee incident, issue, and ticket management processes, including documentation, assignment, tracking, escalation, and timely resolution.
• Provide on-call and after-hours incident-management support for production releases and unplanned system issues.
• Identify, document, and mitigate operational risks and production issues.
• Manage internal and external escalations and ensure issues are assigned, communicated, and resolved effectively.
• Oversee external vendors responsible for system development, maintenance, enhancements, and production support.
• Work with contract-monitoring teams to establish, track, and enforce service-level agreements.
• Ensure compliance with applicable CMS, SSA, cybersecurity, and operational requirements.
• Monitor security findings and recommendations through completion.
• Develop, implement, monitor, and maintain Standard Operating Procedures.
• Identify operational practices that do not align with approved SOPs and coordinate corrective actions.
• Oversee release-management activities, including stakeholder communications, implementation planning, readiness assessments, approval gates, and post-implementation monitoring.
• Support change-management activities through backlog grooming, backlog maintenance, documentation, and governance compliance.
• Assign and oversee team workloads while ensuring mission-critical operational objectives are met.
• Prepare reports, presentations, status updates, issue summaries, and executive-level communications.
• Promote a professional, collaborative, safe, and productive working environment.

• Bachelor's degree in a technical, business, healthcare, information systems, or related field.

Substitution:
Five or more years of equivalent experience in business analysis, systems analysis, or computer systems development and modification may substitute for the degree requirement.

• Five or more years of experience managing system operations or administrative program functions involving healthcare claims and/or encounter processing.
• Five or more years of project-management experience leading system implementations, replacements, upgrades, or enhancements.
• Three or more years of experience managing external vendors that provide system development or technical services.
• Ability and willingness to provide on-call and after-hours incident-management support.
• Current AWS Cloud certification.

• Experience managing the operations of Medicaid Enterprise Systems.
• Knowledge of Medicaid eligibility, enrollment, managed care, claims, encounters, payments, and MMIS domain concepts.
• Knowled…